scholarly journals Assessment of cognitive dysfunction using the Montreal Cognitive Assessment test: rate, severity and comparison with the Clock test alone in a population of patients referred for TAVI

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
C Monnin ◽  
M Besutti ◽  
F Ecarnot ◽  
B Guillon ◽  
M Chatot ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
Montreal Cognitive Assessment ◽  
Routine Practice ◽  
Clock Drawing Test ◽  
Transcatheter Aortic Valve ◽  
The Mean ◽  
Time Required ◽  
Moca Score

Abstract Background Although not recommended in routine practice, the detection and quantification of Cognitive Dysfunction (CD) in older patients might have an impact on clinical decisions. We assessed the rate and severity of CD in an unselected population of patients referred for Transcatheter Aortic Valve Implantation (TAVI) using the Montreal Cognitive Assessment (MoCA) and using the Clock Drawing Test (ClockT) alone. Methods The MoCA was performed before TAVI by an experienced operator. The ClockT was scored out of 10 points according to the Rouleau rating scale. CD was defined according to the MoCA score: No CD if score ≥26, mild CD if score 18–25, moderate if 10–17 and severe if <10. Inter-observer reliability of scoring on the ClockT was estimated with the Bland-Altman method. Agreement between MoCA scores and the ClockT for ruling out and for detecting CD were measured with the Kappa coefficient. Results MoCA was performed in 83 consecutive patients referred for TAVI, median age 85 years. The mean time required for assessment was 11±2 min for the MoCA and 3±2 min for the ClockT. The mean MoCA score was 21±4.5: CD was excluded in 17 (20%) pts, mild CD was found in 50 (60%), moderate in 15 (18%) and severe in one (1%). The median ClockT score was 8 (interquartile 6; 9), with excellent inter-observer concordance (Kappa= 0.84). Overall, 51% of the variance of the MoCA score was explained by the ClockT alone according to multiple regression. A ClockT <7 detected a group with significantly lower MoCA score, compared to pts with higher ClockT scores (figure). Conclusion Among patients referred for TAVI, CD can be excluded using the MoCA test in 20%, while moderate or severe CD is observed in 18%. The ClockT alone is faster to implement, reliable to interpret and enabled detection of patients with moderate CD when Rouleau scoring was <7. Funding Acknowledgement Type of funding sources: None.

scholarly journals Montreal Cognitive Assessment in a 63- to 65-year-old Norwegian Cohort from the General Population: Data from the Akershus Cardiac Examination 1950 Study

2017 ◽  
Vol 7 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Håkon Ihle-Hansen ◽  
Thea Vigen ◽  
Trygve Berge ◽  
Gunnar Einvik ◽  
Dag Aarsland ◽  
...  
Keyword(s):  
Higher Education ◽  
General Population ◽  
Cognitive Assessment ◽  
Population Data ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Normal Cognitive Function ◽  
The Mean ◽  
The Impact ◽  
Moca Score

Aims: To investigate Montreal Cognitive Assessment (MoCA) test scores in a cohort aged 63–65 years from a general population in relation to the proposed cut-off score of 26 for mild cognitive impairment (MCI) and to explore the impact of education. Methods: MoCA scores were assessed in the Akershus Cardiac Examination 1950 Study, a cross-sectional cohort study of all men and women born in 1950 living in Akershus County, Norway. The participants were aged 63–65 at the time of data collection. Results: MoCA scores were available in 3,413 participants, of which 47% had higher education (>12 years). The mean MoCA score was 25.3 (95% confidence interval [CI] 25.2–25.4), and 49% had a score below the suggested cut-off of 26 points. Those with higher education had significantly higher scores (mean 26.2, 95% CI 26.1–26.3 vs. 24.4, 95% CI 24.3–24.6, p < 0.001). Conclusions: Approximately 50% scored below the cut-off score of 26 points, suggesting that the cut-off score may have been set too high to distinguish normal cognitive function from MCI. Educational level had a significant impact on MoCA scores.

NCOG-44. FEASIBILITY AND UTILITY OF THE MONTREAL COGNITIVE ASSESSMENT IN ROUTINE CLINICAL EXAMS AND TELEHEALTH VISITS IN NEURO-ONCOLOGY

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi161-vi162
Author(s):  
Varna Jammula ◽  
Elizabeth Vera ◽  
James Rogers ◽  
Alexa Christ ◽  
Heather Leeper ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
College Education ◽  
Symptom Burden ◽  
Primary Brain Tumor ◽  
Montreal Cognitive Assessment ◽  
Standardized Assessments ◽  
Routine Practice ◽  
Clinical Settings ◽  
Survey Responses ◽  
Moca Score

Abstract Cognitive dysfunction (CD) is common among primary brain tumor (PBT) patients and adds to the overall symptom burden. Standardized assessments able to be incorporated into routine clinical in-person and telehealth care are needed. Here, we report the feasibility, utility, and satisfaction with use of the Montreal Cognitive Assessment (MoCA) in telehealth and clinical settings by trained clinical providers. Feasibility and provider satisfaction were assessed through survey responses, and patient performance on the MoCA, after a reliability check, was reported through descriptive statistics. Seventy-nine MoCAs on 71 patients were completed in clinic (n=55) or telehealth (n=24). Majority of patients were white (83%) males (54%) with high grade PBTs (66%), and half of patients had completed at least a college education. In clinic, providers (n=9) reported the MoCA took 5-20 minutes to complete, was easy to incorporate into routine practice (78%), believed it was accurate in assessing cognition (67%), and was useful in determining treatment (88%). The average in-person MoCA score was 25 (range: 6 to 30), with 31% of scores classified as abnormal (≤26). In telehealth, providers (n=11) found the administration of the MoCA prior to attending participation in the telehealth visit helpful (75%), discussed the results with their clinical team (75%) and patient (63%), and believed the MoCA was accurate in assessing cognition remotely (63%). On average, patients took 13 minutes (9-22) to complete testing, with three tests discordant on reliability scoring and one patient unable to complete testing. The average telehealth MoCA score was 26 (12-30), with 29% of scores classified as abnormal. Overall, testing was feasible in both clinical and telehealth settings, and providers reported satisfaction with its use. Future studies should evaluate validity in a larger sample and include analysis of relevant cut-off scores, impact of disease, tumor treatment, and genomic predispositions.

scholarly journals Association between Primary Open-Angle Glaucoma and Cognitive Impairment as Measured by the Montreal Cognitive Assessment

2018 ◽  
Vol 18 (5-6) ◽  
pp. 315-322 ◽  
Author(s):  
Makayla McCoskey ◽  
Victoria Addis ◽  
Kendall Goodyear ◽  
Prithvi S. Sankar ◽  
Gui-Shuang Ying ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Linear Trend ◽  
Montreal Cognitive Assessment ◽  
Open Angle ◽  
Rnfl Thickness ◽  
The Mean ◽  
Moca Score

Background: It is currently unclear whether primary open-angle glaucoma (POAG) affects neurological functions outside of vision, such as cognition. Objective: This study examined the association between POAG and cognitive impairment in African Americans. Methods: Masked interviewers administered the Montreal Cognitive Assessment (MoCA) to patients enrolled in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study at the Scheie Eye Institute. Cases were further assessed for retinal nerve fiber layer (RNFL) thickness and visual field (VF) loss. Univariate and multivariate linear regression analyses were performed to compare mean MoCA score between cases and controls and to assess the association between POAG severity and MoCA score. Results: A total of 137 patients completed the MoCA, including 70 cases and 67 controls. The mean age ± SD was 68.7 ± 11.2 years for cases and 65.7 ± 10.4 years for controls (p = 0.11). The mean MoCA total score (out of 30 points) was 20.3 among POAG cases and 21.3 among controls (mean difference = –1.03, 95% confidence interval, CI = –2.54 to 0.48, p = 0.18). After adjusting for age, gender, education level, diabetes, hypertension, and smoking status, the mean difference in the MoCA total score between cases and controls was –0.64 (95% CI = –1.72 to 0.45, p = 0.25). Among cases, more VF loss was associated with lower total MoCA score for mean deviation (adjusted linear trend p = 0.02) and VF index (adjusted linear trend p = 0.03). There was no significant association between average RNFL thickness and total MoCA score. Conclusions: POAG cases and controls had similar neurocognitive function as measured by the MoCA. Among POAG cases, worse VF loss was associated with lower MoCA. Future studies are needed to further elucidate the clinical effect of neuropathy in POAG.

Hubungan Kadar Prokalsitonin dan Kejadian Postoperative Cognitive Disfunction (POCD) ada Pasien yang Menjalani Operasi Ganti Katup Jantung Di Rumah Sakit Umum Pusat Dr. Kariadi Semarang

2021 ◽  
Vol 13 (3) ◽  
pp. 153-164
Author(s):  
Widya Istanto Nurcahyo ◽  
Ari Kurniawan ◽  
Yulia Wahyu Villyastuti ◽  
Taufik Eko Nugroho ◽  
Satrio Adi Wicaksono ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Consecutive Sampling

Latar belakang:Postoperative cognitive dysfunction atau POCD adalah gangguan fungsi kognitif akibat inflamasi pasca prosedur pembedahan. Angka kejadian POCD pasca pembedahan kardiak lebih tinggi dibandingkan pembedahan non-kardiak. POCD diduga diakibatkan oleh respons inflamasi sistemik. Prokalsitonin menjadi salah satu mediator inflamasi yang berperan terhadap peningkatan risiko inflamasi saat operasi yang memicu kejadian POCD pascaoperasi ganti katup jantung. Inflamasi disebabkan oleh pelepasan protein fase akut yaitu prokalsitonin dan sitokin proinflamasi lainnya yang menyebabkan terganggunya sawar darah otak dan mengganggu neurotransmisi sehingga terjadi POCD.Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan peningkatan kadar Prokalsitonin terhadap POCD pada pasien yang menjalani operasi ganti katup jantung di RSUP Dr. Kariadi.Metode: Penelitian ini adalah penelitian analitik observasional dengan pendekatan cross sectional. Populasi penelitian ini adalah seluruh pasien yang menjalani operasi ganti katup jantung di RSUP Dr. Kariadi pada bulan Juni 2020- Desember 2020. Sampel penelitian sebanyak 19 subjek didapatkan dengan teknik consecutive sampling. Pada subjek penelitian dilakukan pengukuran kadar serum prokalsitonin sebelum pembedahan dan hari pertama pasca pembedahan, kemudian dilakukan pemeriksaan fungsi kognitif dengan montreal cognitive assessment-indonesia (MoCA INA) pada hari ketiga pasca pembedahan. Data dianalisis dengan uji korelasi spearman.Hasil: Dari 19 subjek penelitian, terdapat 13 responden (68,4%) yang mengalami POCD. Rerata peningkatan prokalsitonin pada pasien POCD adalah 5,22 dengan standar deviasi 12,50 sedangkan peningkatan prokalsitonin pada pasien non POCD adalah 0,21 dengan standar deviasi 0,45. Berdasarkan uji korelasi spearman, diperoleh hasil bahwa terdapat hubungan yang signifikan antara peningkatan kadar prokalsitonin terhadap POCD pascaoperasi ganti katup jantung (p=0,004).Kesimpulan: Terdapat hubungan yang signifikan antara perbedaan kadar Prokalsitonin terhadap POCD pascaoperasi ganti katup jantung di RSUP Dr. Kariadi.

scholarly journals P1508COGNITIVE IMPAIRMENT A RISK FACTOR FOR NON ADHERENCE TO MEDICAL MANAGEMENT AMONG PATIENTS ON MAINTENANCE HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Larisa Shehaj ◽  
Merita Rroji (Molla)
Keyword(s):  
Cognitive Assessment ◽  
Descriptive Analysis ◽  
Strong Association ◽  
Montreal Cognitive Assessment ◽  
Maintenance Hemodialysis ◽  
Medical Adherence ◽  
Cognitive Screening ◽  
High Prevalence ◽  
The Mean ◽  
And Gender

Abstract Background and Aims Patients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment (CI) compared with the general population. Subtle changes can impact engagement with healthcare, comprehension, decision-making, and medication adherence. The Montreal Cognitive Assessment (MoCA) test was reported to represent a suitable cognitive screening tool for hemodialysis patients. Our study aimed to assess the prevalence of CI in CKD patients undergoing hemodialysis, socio-demographic and patient-related variables affecting CI and relationship with medical adherence. Method Out of 65 patients in the HD unit, 58 patients (mean age 59.16±10.61 years old and meantime in therapy 6.93±5.03 years) accepted to participate in the study. The Montreal Cognitive Assessment (MoCA) scale was administered to patients. Patients with a MoCA global score 24/30 were considered cognitively impaired. Descriptive analysis was done for the socio-demographic and clinical variables. Results The mean total MoCA score for all the patients were 22.77679±3.8. Thirty seven patient 63.7% were evaluated with CI where 67.5 % with Mild CI (MCI) and 32.5% with severe CI (SCI) under 20 points). MoCA subscale analysis revealed that the mean score for visuospatial/executive domain and attention were the lowest with 5.38±1.3 /8max and 2.82±1.67/6 max and scores for orientation were the highest 5.94±0.59/6 max. MCI was related to vintage to dialysis (p &lt; .00001) and education years (p&lt;0.05) but not with age (p&gt;0.05) and gender (p&gt;0.05) where severe CI was related to age and comorbidity ( p&lt;0.05 and P&lt;0.01, respectively. We found a strong association between low scores and medical adherence (p&lt;0.001). Conclusion: In hemodialysis, we have a relatively high prevalence of CI and screening for impairment should be considered in all adults with ESRD. Older age, vintage on dialysis, and comorbidity were associated with lower scores. The visuospatial/executive domain and attention were mostly affected. The association between low scores and medical adherence show a high risk for this group of patients.

scholarly journals Attention Deficits After Aneurysmal Subarachnoid Hemorrhage Measured Using the Test of Variables of Attention

Stroke ◽  
2015 ◽  
Vol 46 (5) ◽  
pp. 1374-1376 ◽  
Author(s):  
Svante Wallmark ◽  
Erik Lundström ◽  
Johan Wikström ◽  
Elisabeth Ronne-Engström
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cognitive Assessment ◽  
Performance Test ◽  
Rating Scale ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Continuous Performance Test ◽  
Attention Deficits ◽  
Montreal Cognitive Assessment ◽  
Routine Magnetic Resonance Imaging ◽  
Computer Based

Background and Purpose— The aim of this pilot study was to assess attention deficits in patients with aneurysmal subarachnoid hemorrhage using the test of variables of attention (TOVA). This is a computer-based continuous performance test providing objective measures of attention. We also compared the TOVA results with the attention and concentration domains of Montgomery Åsberg Depression Rating Scale and Montreal cognitive assessment, 2 examiner-administrated neuropsychological instruments. Methods— Nineteen patients with moderate to good recovery (Glasgow outcome scale, 4–5) were assessed using the TOVA, Montgomery Åsberg Depression Rating Scale, and Montreal cognitive assessment. The measurements were done when the patients visited the hospital for a routine magnetic resonance imaging control of the aneurysm. Results— TOVA performance was pathological in 58%. The dominating pattern was a worsening of performance in the second half of the test, commonly a failing to react to correct stimuli. We found no correlation between TOVA and the performance in concentration and attention domains of Montgomery Åsberg Depression Rating Scale and Montreal cognitive assessment. Conclusions— Attention deficits, measured by the TOVA, were common after subarachnoid hemorrhage. This should be further studied to improve outcome.

scholarly journals The Montreal Cognitive Assessment (MoCA) as a screening test for cognitive dysfunction in multiple sclerosis

2016 ◽  
Vol 25 (1) ◽  
pp. 57-70 ◽  
Author(s):  
Sandra Freitas ◽  
Sónia Batista ◽  
Ana Cristina Afonso ◽  
Mário R. Simões ◽  
Lívia de Sousa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Cognitive Assessment ◽  
Screening Test ◽  
Montreal Cognitive Assessment

scholarly journals Impact of Cognitive Dysfunction in the Middle East Depressed Patients: The ICMED Study

2018 ◽  
Vol 14 (1) ◽  
pp. 270-283 ◽  
Author(s):  
Abdulqader Al Jarad ◽  
Ahmad Al Hadi ◽  
Ali Al Garatli ◽  
Aly Akram ◽  
Dakhil Alsaeidi ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
United Arab Emirates ◽  
Rating Scale ◽  
Common Factor ◽  
High Rate ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Mean ◽  
The Impact

Background:Major depressive disorder is a common condition with a high rate of recurrence, chronicity, and affecting economic burden, including disability in the workplace, which leads to negative consequences on both individuals and society.Objectives:This study aimed to estimate the impact of cognitive dysfunction, as declared by the patient, on performing daily tasks/activities among patients with major depression disorder (MDD).Methods:This investigation is based on multinational cross-sectional survey of 499 workers recruited from the Kingdom of Saudi Arabia (KSA) and United Arab Emirates (UAE). We assessed the severity of depression by Hamilton Depression Rating Scale (HDRS). Impact of Depression in the Workplace in Europe Audit (IDEA) survey and trial making test (TMT) parts A and B were used to assess the impact of cognitive dysfunction on performing daily tasks/activities in adult patients presented with MDD.Results:A total of 499 persons were included in this study, aged 18–66 years, current workers and managers. Of them, 17.8% were normal (remitted), 22.4% were mildly depressed, 23.4% were moderately depressed, 8.6% were severely depressed, and 27.7% were very severely depressed at the time of the study according to HDRS. Common symptoms attributable to depression were low mode or sadness (89.8%), followed by insomnia (75.2%) and crying (70.9%). Of them, low mode or sadness was the most common factor affecting the work performance (90.2%). About 66.3% of participants diagnosed with depression by a doctor/medical professional. Awareness of the disease was recognizable by patients’ managers in only 31.9% of the cases. Furthermore, 45.3% of cases had taken off work due to depression with mean duration of 38.7 (95% CI 37.7 to 39.7) days. The mean TMT parts A and B score were 69.2 (95% CI 66.3 to 72.2) and 126.6 (95% CI 121 to 132), respectively. Lastly, a significant positive correlation between the mean score for HDRS and TMT-A and B scores was observed.Conclusion:Depression affects work productivity and work environment with negative consequences to countries’ economy. Awareness of depression in the workplace in KSA and UAE is still suboptimal. The personal and societal burden of this issue cannot be neglected when we become aware of the proportion of affected people.

scholarly journals Construct Validity and Psychometric Properties of the Tamil (India) Version of Montreal Cognitive Assessment (T-MoCA) in Elderly

2021 ◽  
Author(s):  
M Abdulkarim ◽  
J Venkatachalam
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Montreal Cognitive Assessment ◽  
Clinical Dementia Rating ◽  
Sensitivity Specificity ◽  
Test Retest Reliability

Background: The Montreal Cognitive Assessment (MoCA) is a neuropsychological cognitive tool developed and adapted widely in various languages for screening mild cognitive impairment (MCI). Objectives: The present study aimed to evaluate the psychometric properties of the Tamil (India) Version of MoCA (T-MoCA) and further examine the construct validity of the tool.Method: The authors conducted internal consistency, test-retest, sensitivity-specificity, and construct validity using 233 Tamil-speaking elderly participants. The inclusion criteria of the study participants were 0.5 or less than 0.5 scores in the Clinical Dementia Rating scale (CDR). Further, T-MoCA was used to screen MCI. Results: The result showed that the T-MoCA had high internal consistency (0.83) and high test-retest reliability (0.92). Receiver operating characteristic (ROC) analyses showed an area under the curve (AUC) of 0.91 (95% CI 0.87-0.94) for detecting MCI. Furthermore, the optimal cut-off score to detect MCI was 24, accommodated a sensitivity and specificity of 88.4% and 77.9%, respectively. Conclusions: The Tamil (India) version of the MoCA maintained its core diagnostic properties, furnishing it a valid and reliable tool for the screening of MCI. Also, its latent dimensions help to understand the elders’ cognitive function in a better way.

scholarly journals Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series

2021 ◽  
Vol 12 ◽  
Author(s):  
Aline de Moura Brasil Matos ◽  
Flavia Esper Dahy ◽  
João Victor Luisi de Moura ◽  
Rosa Maria Nascimento Marcusso ◽  
Andre Borges Ferreira Gomes ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Case Series ◽  
Oligoclonal Bands ◽  
Clock Drawing Test ◽  
Neurologic Sequelae ◽  
Cognitive Disturbances ◽  
Csf Pleocytosis ◽  
The Mean ◽  
Antibody Dynamics ◽  
State Examination

Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted to nasal/throat swabs or to IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients with previous mild or moderate COVID-19 who developed subacute cognitive disturbances.Methods: From June 1 to August 15, 2020, seven individuals 18 to 60 years old, with confirmed mild/moderate COVID-19 and findings consistent with encephalopathy who were observed &gt;7 days after respiratory symptom initiation, were screened for cognitive dysfunction. Paired sera and CSF were tested for SARS-CoV-2 (IgA, IgG ELISA, and RT-PCR). Serum and intrathecal antibody dynamics were evaluated with oligoclonal bands and IgG index. Cognitive dysfunction was assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test (CDT).Results: All but one of our patients were female, and the mean age was 42.6 years. Neurologic symptoms were first reported a median of 16 days (IQR 15–33) after initial COVID-19 symptoms. All patients had headache and altered behavior. Cognitive dysfunction was observed mainly in phonemic verbal fluency (MoCA) with a median of six words/min (IQR 5.25–10.75) and altered visuospatial construction with a median of four points (IQR 4–9) (CDT). CSF pleocytosis was not detected, and only one patient was positive for SARS-CoConclusions: A subacute cognitive syndrome suggestive of SARS-CoV-2-initiated damage to cortico-subcortical associative pathways that could not be attributed solely to inflammation and hypoxia was present in seven individuals with mild/moderate COVID-19.

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