# Comparative Analysis of MoCA and DigiMoCA Test Results: A Pilot Study
###### Abstract  
This study examined the cognitive performance of older adults aged 60 and above using the Montreal Cognitive Assessment (MoCA) test and DigiMoCA, a digital tool for cognitive screening administered by means of a smart speaker, to investigate whether the additional variables utilised by DigiMoCA allow for the identification of significant differences between individuals with depressive symptoms and those with mild cognitive impairment, which are not detected using the original MoCA test. A total of 73 senior adults located in Northwestern Spain, 22 male and 51 female, participated in this study. Subjects were divided into four groups based on the presence of depressive symptoms and mild cognitive impairment, with the aim of analysing the results of each dimension of the MoCA and DigiMoCA tests and assessing the additional insights provided by the digital administration tool. The results indicate significant differences among groups. Individuals with depressive symptoms exhibited poorer performance in forward number span, attention, and clock drawing compared to healthy controls. Furthermore, individuals with depressive symptoms and mild cognitive impairment exhibited significantly worse memory and orientation compared to those with cognitive impairment alone. Correlations revealed that a greater severity of depressive symptoms was associated with poorer performance across cognitive domains, including visuospatial skills, attention, language, memory, and phonemic verbal fluency. This study also illustrated how the exploitation of additional variables systematically captured by digital instruments, such as completion times or response delays to individual interactions, may facilitate the early identification of cognitive and depressive conditions, providing initial evidence about the importance of integrating advanced digital tools in cognitive assessment to inspire the development of more effective, personalised interventions. clock drawing test; cognition assessment; depression; DigiMoCA; digital administration; mild cognitive impairment; MoCA  
which can make it even more difficult for them to actively participate in their communities and maintain social and family relationships. Early studies about this topic focused primarily on demonstrating that depressed and non-depressed people differ in the content of their thoughts. These investigations provided support for the formulation that depression is characterised by negative automatic thoughts and biases in attention, interpretation, and memory [1,2]. The deterioration of processing speed and executive, attentional, and amnestic functions are frequent findings [3], and, as a consequence, cognitive symptoms such as difficulty in concentrating or slowness in thinking and decision making are among the diagnostic criteria included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for major depressive disorder (MDD) [4]. Late-life depression refers to depression that occurs in individuals aged 65 and above without a prior history of depression. Unlike early-onset depression, late-life depression in the elderly often presents with less prominent symptoms of sadness, particularly when characterised by cognitive deficits as the primary symptom, can be mistaken for dementia in older adults. Therefore, it is essential to conduct a thorough mental status examination and cognitive testing before reaching a definitive diagnosis [5, 6, 7, 8]. A systematic review conducted by [PERSON] and colleagues in 2019 [9] comprehensively analysed and synthesised the evidence regarding the relationship between affective problems and cognitive decline in older adults. This multilevel meta-analysis revealed a significant association between depression, assessed both as a binary and continuous predictor, and the decline in cognitive status. Deficits in various domains, including attention, executive functions, memory, and processing speed were among the symptoms most frequently reported by patients and their relatives.