People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG’s activity increased by 52.89 aerobic steps at 6 months and the CG’s activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: −444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: −659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.

While the Montreal Cognitive Assessment (MoCA) is a reference instrument for cognitive screening, sociodemographic factors such as age and education can affect its diagnostic accuracy. The aims of this systematic review were to characterize the use of the MoCA in samples from Spain and to analyze its psychometric properties. A systematic search was conducted in the main scientific databases up to February 2025. The evidence was synthesized using a dual strategy: a quantitative synthesis (meta-analysis and meta-regression) for the first aim, and a narrative synthesis of psychometric properties guided by the COSMIN framework for the second. Eighty studies were included: 78 ( n = 7,457) in the meta-analysis. The mean MoCA score was 22.85, with substantial heterogeneity ( I ² = 99.3%). Meta-regression explained 62% of this variability, identifying age ( β = −0.19/year) and education ( β = 1.28/year) as the most significant predictors. Scores were lower in dementia and mild cognitive impairment compared with healthy participants. The narrative synthesis of psychometric properties showed that the MoCA has adequate psychometric properties in the studies conducted in Spain, with good internal consistency (Cronbach’s α : 0.76–0.90) and criterion-related validity (area under the curve: 0.78–0.96). The robustness of the findings was confirmed by sensitivity analyses. In conclusion, the MoCA is a valid and widely used tool in Spain, but its performance is strongly modulated by age and education, supporting the use of adjusted normative data rather than a single universal cut-off.

Episodic memory in the 7 Minute Screen is assessed by the Enhanced Cued Recall (ECR) test. The ECR test is composed of three phases, Identification, Immediate Recall, and Free and Cued Recall. However, just the last phase is considered for the total score. We believe that collecting the performance data of the Identification and Immediate Recall phases could provide information regarding possible difficulties or impairments in the different aspects involved in the temporal mnesic process of acquisition of new information, such as in working memory or visual identification. The objective was to assess the goodness of fit for the three phases of the ECR test using a Confirmatory Factor Analysis (CFA) to show if each phase is separated from each other as a different aspect that participates in the mnesic process. A total of 311 participants greater than 65 years were included in this study. Confirmatory factor analyses were conducted for each individual phase. The analyses show that the ECR test consists of three separate phases that identify different steps of the mnesic process. Individual scores for each phase could allow for investigation of patient performance in different aspects of the memory process and could help in further neuropsychological assessment.

Background: The Montreal Cognitive Assessment (MoCA) is widely used for cognitive screening, but its dimensionality and domain-specific accuracy require validation with methods for ordinal items. The objective was to analyze the internal structure of the MoCA in a cognitive impairment-free Spanish community sample and examine its relationship with variables potentially related to the risk of cognitive impairment. Method: A total of 1,767 Spanish adults (aged 18-89 years) were assessed in primary care centers using the MoCA, and sociodemographic and health variables were recorded. Internal structure and metric properties were analyzed using factor models and item response theory, as well as their association with external variables and the concordance of the resulting solution. Results: The theoretical models tested did not demonstrate adequate fit. Cross-validation identified a 12-item solution in two correlated factors (Memory and Multiple), with excellent fit (CFI = .991; RMSEA = .019) and latent correlation r = .63. The abbreviated version showed high concordance with the total score (ICC = .96) and substantial agreement in dichotomous classification (k = .84). Conclusions: The MoCA exhibited a two-factor structure and consistent associations with external variables such as age, educational level, and vascular risk; a dimensional interpretation is recommended.