Brief ReportMoCA Intraindividual Cognitive Variability in Older Adults With Type 1 DiabetesMascarenhas Fonseca, Luciana PhD*,†; Sheppard, David P. PhD‡; Chaytor, Naomi S. PhD* Author Information *Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane ‡Veterans Affairs Northwest Mental Illness, Research, Education, and Clinical Care, Veterans Affairs Puget Sound Health Care System, Seattle, WA †Old Age Research Group, Department and Institute of Psychiatry, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil The data were sourced from the T1D Exchange Severe Hypoglycemia in Older Adults with Type 1 Diabetes Study; however, the analyses, content, and conclusions presented herein are solely the responsibility of the authors and have not been reviewed or approved by the T1D Exchange Severe Hypoglycemia in Older Adults with Type 1 Diabetes Study. The original data collection was supported through the Leona M. and Harry B. Helmsley Charitable Trust. This work was supported by an Alzheimer’s Association Grant (AARFD-21-851373) and in part by resources from the Department of Veterans Affairs Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, and the VA Puget Sound Health Care System, Seattle, Washington. The authors declare no conflicts of interest. Reprints: Luciana Mascarenhas Fonseca, PhD, Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202 (e-mail: [email protected]). Alzheimer Disease & Associated Disorders ():10.1097/WAD.0000000000000534, November 2, 2022. | DOI: 10.1097/WAD.0000000000000534 Buy PAP Metrics Abstract Older adults with type 1 diabetes (T1D) may have an elevated risk of developing Alzheimer disease and related dementia. Higher intraindividual cognitive variability (IICV) has been proposed as a novel risk factor of Alzheimer disease and related dementia. Here, we examined the association between cross-domain IICV measured using the Montreal Cognitive Assessment (MoCA) and cognitive impairment measured using traditional neuropsychological tests in older individuals with T1D. Participants with T1D (N=201) completed both the MoCA and a battery of traditional neuropsychological tests. Participants with cognitive impairment, determined using traditional tests, had significantly higher IICV scores and significantly lower total MoCA scores (P<0.001). However, the effect of the total score was greater than that of the IICV score on the likelihood of cognitive impairment (total odds ratio=3.50, IICV odds ratio=2.03, P<0.001). The MoCA total score performed better than the MoCA IICV score in identifying T1D individuals classified with cognitive impairment. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.