IRT-based analyses indeed proved to yield relevant insights to performance interpretations for instance, executive- and memory-related items were often shown to be highly informative. To this last end, Item Response Theory (IRT) analyses have been conducted on MoCA items to assess both their sensitivity and discriminative capability. Moreover, information regarding single items can further help practitioners interpret test scores by qualitatively assigning different weights to different items. A widespread approach that allows a flexible use of cognitive screening tests is to provide norms for their domain-specific sub-tests. Psychometric investigations on the MoCA have been carried out both at the sub-test and the single-item levels. In Italy, the MoCA has been adapted and standardized-and both its statistical properties and clinical usability thoroughly examined. The MoCA is a rapid (5–10’) screening test which evaluates both non-instrumental (executive functioning, attention) and instrumental (language, memory, visuo-spatial abilities, orientation) domains. The Montreal Cognitive Assessment (MoCA) is one of the most widespread and psychometrically robust screening tools for cognitive impairments of graded severity.

Fine-grained, adaptive psychometric approaches can thus help solve interpretation issues to facilitate diagnostic processes by magnifying informativity. Compared to screening tests for dementia, those aimed at detecting mild-to-moderate cognitive impairment may be harder for practitioners to interpret because of (a) the magnitude of the target construct (i.e., the deficit) being less obvious and (b) the amount of information provided by the test being limited. Cognitive screening/first-level tests allow an estimate of global efficiency/functioning by adequately balancing between informativity and practicality of usage.

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