Minimal Clinically Important Difference of the Loewenstein Occupational Therapy Cognitive Assessment–Geriatric (LOTCA–G) in People With Dementia

Abstract

Abstract Importance: The Loewenstein Occupational Therapy Cognitive Assessment–Geriatric (LOTCA–G) can provide multifaceted and comprehensive measures of cognitive function with reduced literacy demands; however, its minimal clinically important difference (MCID) has not been determined for interpreting the change scores. Objective: To establish the LOTCA–G MCID for people with dementia. Design: Psychometric field study. Setting: Data were collected in communities. Participants: Forty-nine participants with mild to moderate dementia who were enrolled in previous research investigating the effects of cognitive stimulation–related interventions with equivalent training hours. Outcomes and Measures: The Mini-Mental State Examination and LOTCA–G were used to assess cognitive function before and after the interventions. The anchor-based and distribution-based approaches were used to estimate the LOTCA–G MCID. Results: Using the anchor-based method, we defined 16 participants as the improvement group, with a mean change score of 5.75 points (the first MCID estimate). The second MCID estimate was 6.23 points, which we calculated from the 49 participants by using the distribution-based method with the medium effect size. Conclusions and Relevance: Current results suggest that a LOTCA–G change score greater than 5.75 points should be considered as meaningful change for people with dementia. It is important to consider the LOTCA–G MCID as one of the indexes for determining the success of interventions in people with dementia. What This Article Adds: This study is the first to report the LOTCA–G MCID for dementia. Establishing an MCID for standardized cognitive assessment tools for the aging population can be used to support evidence-based practice in rehabilitation clinics.