# Comparative Analysis of MoCA and DigiMoCA Test Results: A Pilot Study
## 4 Discussion  
The results obtained revealed significant differences among groups. These results are consistent with previous research, such as that of [PERSON] et al. (2019), where it was found that patients with depressive symptoms showed significantly worse results compared to healthy controls in all neuropsychological tests included in their study (i.e., verbal fluency, processing speed, executive functioning, sustained attention, long- and short-term memory performance, visuospatial working memory, verbal working memory, and verbal fluency). Cognitive impairments are an important aspect of MDD (2019, 2020), although not all subjects report the same differences, for example in attention or language (2020). Our data show that individuals with depressive symptoms exhibited differences in forward numbers, attention, and clock drawing performance compared with the healthy control group, evidencing the progressive loss of cognitive faculties measured through the MoCA when comparing these two groups. The most affected dimensions are visuospatial skills, memory, attention, and language; however, only significant differences in attention were found. Language (\(p\) = 0.053) and visuospatial skills/EF (\(p\) = 0.054) have significance values close to 0.05. On the other hand, the CDT used to assess executive and visuospatial ability showed a significant differentiation between both groups, demonstrating worse performances for people with depressive symptoms (2020). We can find in the literature studies that demonstrate that MDD is reliably associated with poor performances on neuropsychological measures of executive function, with effectsizes ranging from 0.32 to 0.97 [33; 34]. In fact, it can be argued that difficulties in executive functioning and visuospatial memory are the best predictors of depression in the elderly [35]. Our study evidences poorer performances as depressive and MCI symptomatology increases, with a notable decrease in all domains of cognitive performance compared to the other groups. In fact, the correlation values obtained confirm identifying patterns between depressive symptomatology and cognitive variables, thus indicating that relevant depressive symptoms imply poorer performances in visuospatial skills, including the CDT, attention, language, memory, and DigiMoCA's factor 2, which include letter mistakes, letters, second sentence, and week guessing [36]. The group of people with depressive symptoms only did not show significant differences compared to those with MCI, except for the identification variable, where the former had a better performance. In addition, the results obtained indicate that individuals with DS and MCI show significantly poorer performances in memory and orientation compared to those without depressive symptoms exhibiting mild cognitive impairment. The onset of depressive symptoms aggravates deficits in memory and orientation in people with MCI, as some studies have previously suggested [3; 37; 38; 39; 40]. On the other hand, when the D+/MCI+ and D+/MCI- groups were compared, significantly poorer performances in visuospatial skills, identification, memory, and orientation were observed in individuals with depressive symptoms and MCI with respect to those with depressive symptoms (D+ MCI-). This suggests that the presence of MCI aggravated cognitive deficits in multiple areas, such as executive/visuospatial skills, attention, and identification [41]. When comparing the group of healthy individuals with those with DS and MCI, significant differences were observed in all cognitive tasks, as expected, in favour of the group of healthy individuals. It is important to note that the DigiMoCA only reveals differences in total scores and in attention and abstraction.