Impaired attention function based on the Montréal Cognitive Assessment in vascular dementia patients with frontal hypoperfusion: The Osaki-Tajiri project

Objectives This study was performed to determine whether multimodal biomarkers are more strongly associated with the Montreal Cognitive Assessment (MoCA) scores compared with the Mini-Mental State Examination (MMSE) scores, and whether they are correlated with the Clinical Dementia Rating (CDR) in patients with subcortical ischemic vascular dementia (SIVD). Methods Patients diagnosed with SIVD were enrolled. Peripheral blood hypersensitive C-reactive protein, white matter lesion volume (WMLV), fractional anisotropy (FA)/mean diffusivity (MD) of whole brain white matter (WBWM), and normal-appearing white matter (NAWM) were measured and correlated with MMSE, MoCA, and CDR scores. Results Bivariate analyses of data from 48 included patients revealed that both MoCA and MMSE were significantly associated with age, education, and FA of NAWM. Only MD of NAWM was correlated with MoCA scores. In partial correlation analysis adjusted for demographic and neuroimaging variables, MD/FA of NAWM and the MoCA scores were significantly correlated. FA/MD of NAWM had a modest trend toward a correlation with the CDR, but it was not significant. Conclusions In the patients with SIVD, FA/MD of NAWM were more strongly related to MoCA scores compared with MMSE scores.

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Montreal Cognitive Assessment (MoCA): Validation Study for Vascular Dementia

Journal of the International Neuropsychological Society ◽

10.1017/s135561771200077x ◽

2012 ◽

Vol 18 (6) ◽

pp. 1031-1040 ◽

Cited By ~ 51

Author(s):

Sandra Freitas ◽

Mário R. Simões ◽

Lara Alves ◽

Margarida Vicente ◽

Isabel Santana

Keyword(s):

Vascular Dementia ◽

Cognitive Assessment ◽

Discriminant Validity ◽

Montreal Cognitive Assessment ◽

Short Version ◽

Cognitive Screening ◽

Homogeneous Sample ◽

Predictive Values ◽

Full Version ◽

Sensitivity Specificity

AbstractThe Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment, having surpassed the well-known limitations of the MMSE. The aim of the present study was to validate the MoCA as well as its short version, which was proposed by the NINDS-CSN VCI Harmonization Standards for screening Vascular Dementia (VaD) patients. The results, based on a homogeneous sample of 34 VaD patients, indicate that the MoCA is a psychometrically valid and reliable instrument for cognitive screening in VaD patients, showing excellent discriminant validity. Both the full and short versions of the MoCA had excellent diagnostic accuracy in discriminating VaD patients, exhibiting an area under curve (AUC) higher than the MMSE [AUC(MoCA full version) = .950; 95% IC = .868–.988; AUC(MoCA short version) = .936; 95% IC = .849–.981; AUC(MMSE) = .860; 95% IC = .754–.932]. With a cutoff below 17 on the MoCA full version and 8 on the short version, the results for sensitivity, specificity, positive and negative predictive values, and classification accuracy were superior compared to the MMSE. In conclusion, both versions of the MoCA are valid, reliable, sensitive and accurate screening instruments for VaD patients. (JINS, 2012, 18, 1–10)

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Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease

Dementia & Neuropsychologia ◽

10.1590/s1980-5764-2016dn1004013 ◽

2016 ◽

Vol 10 (4) ◽

pp. 333-338 ◽

Cited By ~ 5

Author(s):

Vitor Tumas ◽

Vanderci Borges ◽

Henrique Ballalai-Ferraz ◽

Cyrus P. Zabetian ◽

Ignácio F. Mata ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Assessment ◽

Test Methods ◽

Montreal Cognitive Assessment ◽

Cross Sectional ◽

Maximum Score ◽

Dementia Patients ◽

Wide Range ◽

Highly Correlated

ABSTRACT Background: The Montreal Cognitive Assessment (MoCA) is a short global cognitive scale, and some studies suggest it is useful for evaluating cognition in patients with Parkinson's disease (PD). However, its accuracy has been questioned in studies involving patients with low education. Objective: We sought to assess whether some of the MoCA subtests contribute to the low accuracy of the test. Methods: We performed a cross-sectional retrospective analysis of clinical data in a cohort of 71 patients with PD, most with less than 8 years of education. Patients were examined using the MDS-UPDRS, Hoehn and Yahr and the MoCA. The data were analyzed using mainly descriptive statistics. Results: We analyzed the data of 66 patients that were not demented according to the clinical evaluation and classified them using the proposed cut-off MoCA scores for diagnosis of MCI and dementia. Thirteen patients (19.7%) were classified as having normal cognition, 24 (36.3%) MCI and 29 (43.9%) dementia. Patients with dementia had longer disease duration (p=0.016) and lower education (p=0.0001). Total MoCA scores had a an almost normal distribution with a wide range of scores and only one maximum score. Performance on the MoCA was highly correlated with education (correlation coefficient=0.66, p=0.0001). At least five of the 10 MoCA subtests showed significant floor effects. Conclusion: We believe that some of the MoCA subtests may be too difficult to be completed by PD patients with low educational level, thus contributing to the test's poor diagnostic accuracy.

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