Research Article
Issue Date: November/December 2020
Published Online: October 02, 2020
Updated: October 09, 2020
Minimal Clinically Important Difference of the Loewenstein Occupational Therapy Cognitive Assessment–Geriatric (LOTCA–G) in People With Dementia
Author Affiliations
  • Kuan-Yi Li, PhD, OTR, is Associate Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, and Associate Research Fellow, Movement Disorders Section, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.
  • Li-Jung Lin, PhD, CTRS, HTR, is Associate Professor, Graduate Institute of Sport, Leisure, and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan; maru641220@ntnu.edu.tw
Article Information
Alzheimer's Disease and Dementia / Geriatrics/Productive Aging / Neurologic Conditions / Research Articles
Research Article   |   October 02, 2020
Minimal Clinically Important Difference of the Loewenstein Occupational Therapy Cognitive Assessment–Geriatric (LOTCA–G) in People With Dementia
American Journal of Occupational Therapy, 10 2020, Vol. 74, 7406205020. https://doi.org/10.5014/ajot.2020.040550
American Journal of Occupational Therapy, 10 2020, Vol. 74, 7406205020. https://doi.org/10.5014/ajot.2020.040550
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.