scholarly journals Detection of Mild Cognitive Impairment Among Community-Dwelling African Americans Using the Montreal Cognitive Assessment

2018 ◽  
Vol 34 (6) ◽  
pp. 809-813 ◽  
Author(s):  
Heidi C Rossetti ◽  
Emily E Smith ◽  
Linda S Hynan ◽  
Laura H Lacritz ◽  
C Munro Cullum ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Sex Education ◽  
Cognitive Assessment ◽  
Regression Models ◽  
Community Dwelling ◽  
Montreal Cognitive Assessment ◽  
Roc Curve Analysis ◽  
Cut Score

Abstract Objective To establish a cut score for the Montreal Cognitive Assessment (MoCA) that distinguishes mild cognitive impairment (MCI) from normal cognition (NC) in a community-based African American (AA) sample. Methods A total of 135 AA participants, from a larger aging study, diagnosed MCI (n = 90) or NC (n = 45) via consensus diagnosis using clinical history, Clinical Dementia Rating score, and comprehensive neuropsychological testing. Logistic regression models utilized sex, education, age, and MoCA score to predict MCI versus NC. Receiver operating characteristic (ROC) curve analysis determined a cut score to distinguish MCI from NC based on optimal sensitivity, specificity, diagnostic accuracy, and greatest perpendicular distance above the identity line. ROC results were compared with previously published MoCA cut scores. Results The MCI group was slightly older (MMCI = 64.76[5.87], MNC = 62.33[6.76]; p = .033) and less educated (MMCI = 13.07[2.37], MNC = 14.36[2.51]; p = .004) and had lower MoCA scores (MMCI=21.26[3.85], MNC = 25.47[2.13]; p < .001) than the NC group. Demographics were non-significant in regression models. The area under the curve (AUC) was significant (MoCA = .83, p < .01) and an optimal cut score of <24 maximized sensitivity (72%), specificity (84%), and provided 76% diagnostic accuracy. In comparison, the traditional cut score of <26 had higher sensitivity (84%), similar accuracy (76%), but much lower specificity (58%). Conclusions This study provides a MoCA cut score to help differentiate persons with MCI from NC in a community-dwelling AA sample. A cut score of <24 reduces the likelihood of misclassifying normal AA individuals as impaired than the traditional cut score. This study underscores the importance of culturally appropriate norms to optimize the utility of commonly used cognitive screening measures.

scholarly journals The psychometrics and diagnostic properties of the Montreal Cognitive Assessment 5-min protocol in screening for Mild Cognitive Impairment and dementia among older adults in Tanzania: A validation study

2019 ◽  
Author(s):  
Golden Mwakibo Masika ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Adrian Wong ◽  
Rose S.Y. Lin
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Assessment ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Community Dwelling ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Oblique Rotation

Abstract Introduction The prevalence of dementia in Tanzania, as in other developing countries is progressively increasing. Yet international screening instruments for mild cognitive impairment are lacking. The aim of this study was to determine the psychometrics and the diagnostic ability of the Montreal Cognitive Assessment 5 minutes protocol (MoCA-5-min) among older adult in the rural Tanzania. Methods The MoCA-5-min and the IDEA cognitive screening were concurrently administered through face to face to 202 community-dwelling older adults in Chamwino district. Exploratory factor analysis (EFA) using principal component method and oblique rotation was performed to determine the underlying factor structure of the scale. The concurrent, construct as well as predictive validities of the MoCA-5-min were examined by comparing its score with IDEA cognitive screening and psychiatrist’s diagnosis using DSM-V criteria respectively. Results The EFA found that all the MoCA-5-min items highly loaded into one component, with factor loading ranging from 0.550 to 0.879. The intraclass correlation coefficient for 6 weeks test-retest reliability was 0.85. Its strong significant correlation with the IDEA screening (Pearson's r = 0.614, p < 0.001) demonstrated a good concurrent validity. Using the psychiatrist’s rating as the gold standard, MoCA-5-min demonstrated the optimal cut-off score for MCI at 22, which yielded the sensitivity of 80% and specificity of 74%; and dementia at score of 16 giving a sensitivity of 90% and specificity of 80%. Upon stratifying the sample into different age groups, the optimal cut-off scores tended to decrease with the increase in age. Conclusion The MoCA-5-min is reliable and provides a valid and accurate measure of cognitive decline among older population in the rural settings of Tanzania. The use of varying cut-off scores across age groups may ensure more precise discriminatory power of the MoCA-5-min.

scholarly journals The Influence of Education on Chinese Version of Montreal Cognitive Assessment in Detecting Amnesic Mild Cognitive Impairment among Older People in a Beijing Rural Community

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shu'aijun Zhou ◽  
Jianzhong Zhu ◽  
Na Zhang ◽  
Bailing Wang ◽  
Tao Li ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older People ◽  
Cognitive Assessment ◽  
Community Dwelling ◽  
Chinese Version ◽  
Montreal Cognitive Assessment ◽  
Diagnostic Interviews ◽  
Study Participants ◽  
Amnesic Mild Cognitive Impairment

To assess the influence of education on the performance of Chinese version of Montreal cognitive assessment (C-MoCA) in relation to the mini-mental state examination (MMSE) in detecting amnesic mild cognitive impairment (aMCI) among rural-dwelling older people C-MoCA and MMSE was administered and diagnostic interviews were conducted among community-dwelling elderly in two villages in Beijing. The performance of C-MoCA and MMSE in detecting aMCI was evaluated by the area under the ROC curve (AUC). Effect size of education on variations in C-MoCA scores was estimated with general linear model. Among 172 study participants (24 cases of aMCI and 148 normal controls), the AUC of C-MoCA was 0.72 (95% CI = 0.62–0.81, cutoff = 20/21), compared to AUC of MMSE of 0.74 (95% CI = 0.64–0.84, cutoff = 26/27). The performance of both C-MoCA and MMSE was especially poorer among those with low (0–6 years) education. After controlling for gender and age, education (η2= 0.204) had a surpassing effect over aMCI diagnosis (η2= 0.052) on variations in C-MoCA scores. Among rural older people, the MoCA showed modest accuracy and was no better than MMSE in detecting aMCI, especially in those with low education, due to the overwhelming effect of education relative to aMCI diagnosis on variations in C-MoCA performance.

Accuracy of the Montreal Cognitive Assessment in Detecting Mild Cognitive Impairment and Dementia in the Rural African Population

2020 ◽  
Author(s):  
Golden M Masika ◽  
Doris S F Yu ◽  
Polly W C Li
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Concurrent Validity ◽  
Community Dwelling ◽  
Discriminatory Power ◽  
Screening Tools ◽  
Montreal Cognitive Assessment

Abstract Objective The incidence of dementia in the sub-Saharan Africa is rising. However, screening tools for cognitive decline that fits their linguistic and cultural context are lacking. The aim of this study was to determine the accuracy of the Kiswahili version of Montreal Cognitive Assessment (K-MoCA) to detect mild cognitive impairment or dementia among older adults in the rural Tanzania. Methods We recruited 259 community-dwelling older adults in Chamwino district, Tanzania. The concurrent validity and discriminatory power of K-MoCA were examined by comparing its score with IDEA cognitive screening and psychiatrist’s diagnosis using DSM-V, respectively. All the questionnaires were administered in face-to-face interview. Results K-MoCA demonstrated acceptable reliability (Cronbach’s alpha = 0.780). Concurrent validity was evident by its significant correlation with the IDEA screening test (Pearson’s r = 0.651, p &lt; 0.001). Using the psychiatrist’s rating as the reference, the optimal cut-off score for MCI and dementia was 19 and 15, respectively, which yielded the sensitivity of 70% and specificity of 60% for MCI, and sensitivity of 72% and specificity of 60% for dementia. Further analysis indicated that education and age influence performance on K-MoCA. Conclusion Overall, the K-MoCA is a reliable and valid tool for measuring cognitive decline. However, its limited discriminatory power for MCI and dementia may be compromised by the cultural irrelevance of some items.

scholarly journals Psychometric Properties of the Persian Montreal Cognitive Assessment in Mild Cognitive Impairment and Alzheimer Disease

2021 ◽  
pp. 51-57
Author(s):  
Vahid Rashedi ◽  
Mahshid Foroughan ◽  
Negin Chehrehnegar
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Test ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Persian Version

Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.

Abstract 1122‐000036: Demographic and Pharmacological Characteristics of Alzheimer Dementia Patients with Mild Cognitive Impairment stratified by Gender

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Oreoluwa O Coker‐Ayo ◽  
Samuel Nathaniel ◽  
Chika Onuoha ◽  
Nneoma Madubuike ◽  
Lidadi Agbomi ◽  
...  
Keyword(s):  
Gender Differences ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Regression Models ◽  
Operating Characteristic ◽  
Management Strategies ◽  
Roc Curve Analysis ◽  
Alzheimer Dementia ◽  
Dementia Patients ◽  
Specific Factors

Introduction : The role that specific clinical factors play in contributing to gender differences in Alzheimer’s patients with mild cognitive impairment (MCI) is not yet fully understood. In this study, we tested the hypothesis that pharmacological, demographic, and risk factors may contribute to gender difference in Alzheimer’s patients with MCI. Methods : Methods Data collected for 5 years was analyzed using a retrospective data analytical approach on 33,064 Alzheimer patients, including 13,569 men and 19,495 women that presented with MCI. Receiver operating characteristic (ROC) curve analysis and multivariate regression models were used to identify specific factors that contribute to gender differences in MCI patients. Results : Results Our records indicate that women that presented with MCI were more likely to be taking Buspirone (OR = 0.767, 95% CI, 0.683‐0.861, P<0.001) while men within this population were more likely to be taking Galantamine (OR = 0.559, 95% CI, 0.382‐0.818, P<0.001). ETOH use was associated with MCI in both men (OR = 0.696, 95% CI, 0.638‐0.760, P<0.001) and women with Alzheimer’s Dementia (OR = 0.484, 95% CI, 0.442‐0.529, P<0.001). Conclusions : Conclusion Our findings reveal gender differences in men and women that presented with MCI. Management strategies should consider identified factors to provide better care for Alzheimer patients with MCI.

Effect of Brain Training Game on Mild Cognitive Impairment (MCI) in Older Adults

2021 ◽  
Vol 15 (9) ◽  
pp. 2272-2275
Author(s):  
Hafsah Arshad ◽  
Kinza Anwar ◽  
Hafsah Gul Khattak ◽  
Imran Amjad ◽  
Yaser Majeed
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Abilities ◽  
Cognitive Assessment ◽  
Verbal Fluency ◽  
Sampling Technique ◽  
Montreal Cognitive Assessment ◽  
Brain Training ◽  
Neurocognitive Functions

Aim: To determine effects of Kinect- based games on neurocognitive functions in older adults with mild cognitive impairment. Methodology: A quasi experimental pre-post trail was conducted on 18 mild cognitive impairment (MCI) older adults. The subjects were recruited to access cognitive impairment through purposive sampling technique. The inclusion criteria were elderly aged ≥ 50 years, both genders, able to read and write, whereas older adults with severe cognitive impairments, neurological disorders and un controlled comorbidities were excluded. Brain training was provided for 30 minutes with 5-minute warm-up time and 5-minute cool-down time for 6 weeks. Blind assessor measured readings at baseline and after six weeks. The outcome measures were Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MOCA), Trail making test A & B and verbal fluency test (Semantic &Phonemic). The data was analyzed at baseline and after six weeks of intervention Results: Significant improvements were observed in post-test measurements (p <0.05) in MMSE, MoCA, TMT A & B and verbal fluency (Semantic &Phonemic) tests after 6 weeks of treatment. Conclusion: Kinect-based virtual reality games are beneficial in improving cognitive abilities of older adults with mild cognitive impairment. Keywords: Cognitive training, Mild cognitive impairment, Montreal Cognitive Assessment

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