VISUOSPATIAL TESTS TO SCREEN FOR IMPAIRED COGNITION IN PARKINSON'S

2015 ◽  
Vol 86 (11) ◽  
pp. e4.81-e4
Author(s):  
Jeremy Cosgrove ◽  
Stuart Jamieson ◽  
Stephen Smith ◽  
Jane Alty
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Odds Ratio ◽  
Mini Mental State Examination ◽  
Disease Duration ◽  
Screening Tool ◽  
Impaired Cognition ◽  
State Examination ◽  
Normal Cognition ◽  
Moca Score

ObjectiveTo determine which test of visuospatial function – copying a wired cube (‘cube’) or interlocking pentagons (‘pentagons’) – is the best screening tool for detecting cognitive impairment in Parkinson's, as defined by abnormal Montreal Cognitive Assessment (MoCA) score.Methods107 Parkinson's subjects completed the MoCA and copied pentagons from the Mini-Mental State Examination (MMSE). They were classified into two groups based on MoCA score: <26 (cognitive impairment (CI)) or ≥26 (normal cognition (NC)). Cube and pentagons were scored using MoCA and MMSE criteria.ResultsThe CI group (n=57) was older (p 0.032) but disease duration, stage and medication were not different. 28% of CI and 72% of NC correctly copied cube. 69% of CI and 92% of NC correctly copied pentagons. Inability to correctly copy cube (p<0.001) or pentagons (p 0.003) was associated with CI. Age adjusted odds ratio for predicting cognitive impairment was 6.85 (2.97–16.39, p 0.001) for incorrect cube and 4.61 (1.41 – 14.93, p 0.011) for incorrect pentagons.ConclusionsIncorrect cube was the most predictive visuospatial marker of cognitive impairment in Parkinson's. This is potentially useful when assessing cognitive function in a busy outpatient clinic, for example. Larger numbers are required for validation.

scholarly journals Detection of mild cognitive impairment in middle-aged and older adults with obstructive sleep apnoea

2018 ◽  
Vol 52 (5) ◽  
pp. 1801137 ◽  
Author(s):  
Katia Gagnon ◽  
Andrée-Ann Baril ◽  
Jacques Montplaisir ◽  
Julie Carrier ◽  
Sirin Chami ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Obstructive Sleep Apnoea ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Sleep Apnoea ◽  
Screening Tests ◽  
Obstructive Sleep ◽  
State Examination

Obstructive sleep apnoea increases the risk for mild cognitive impairment and dementia. The present study aimed to characterise the ability of two cognitive screening tests, the Mini-Mental State Examination and the Montreal Cognitive Assessment, to detect mild cognitive impairment in adults aged 55–85 years with and without obstructive sleep apnoea.We included 42 subjects with mild and 67 subjects with moderate-to-severe obstructive sleep apnoea. We compared them to 22 control subjects. Mild cognitive impairment was diagnosed by a comprehensive neuropsychological assessment. We used receiver operating characteristic curves to assess the ability of the two screening tests to detect mild cognitive impairment.The two screening tests showed similar discriminative ability in control subjects. However, among the mild and the moderate-to-severe obstructive sleep apnoea groups, the Mini-Mental State Examination was not able to correctly identify subjects with mild cognitive impairment. The Montreal Cognitive Assessment's discriminant ability was acceptable in both sleep apnoea groups and was comparable to what was observed in controls.The Mini-Mental State Examination should not be used to screen for cognitive impairment in patients with obstructive sleep apnoea. The Montreal Cognitive Assessment could be used in clinical settings. However, clinicians should refer patients for neuropsychological assessment when neurodegenerative processes are suspected.

Improving precision in the quantification of cognition using the Montreal Cognitive Assessment and the Mini-Mental State Examination

2011 ◽  
Vol 23 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
Lisa Koski ◽  
Haiqun Xie ◽  
Susanna Konsztowicz
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Ability ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Montreal Cognitive Assessment ◽  
Word Repetition ◽  
Highly Sensitive ◽  
Changes Over Time ◽  
State Examination

ABSTRACTBackground: The Montreal Cognitive Assessment (MoCA) can be used to quantify cognitive ability in older persons undergoing screening for cognitive impairment. Although highly sensitive in detecting mild cognitive impairment, its measurement precision is weakest among persons with milder forms of impairment. We sought to overcome this limitation by integrating information from the Mini-Mental State Examination (MMSE) into the calculation of cognitive ability.Methods: Data from 185 geriatric outpatients screened for cognitive impairment with the MoCA and the MMSE were Rasch analyzed to evaluate the extent to which the MMSE items improved measurement precision in the upper ability ranges of the population.Results: Adding information from the MMSE resulted in a 13.8% (13.3–14.3%) reduction in measurement error, with significant improvements in all quartiles of patient ability. The addition of three-word repetition and recall, copy pentagons, repeat sentence, and write sentence improved measurement of cognition in the upper levels of ability.Conclusions: The algorithm presented here maximizes the yield of available clinical data while improving measurement of cognitive ability, which is particularly important for tracking changes over time in patients with milder levels of impairment.

THE RELATIONSHIP BETWEEN CLOCK DRAWING AND COGNITION IN PARKINSON'S

2015 ◽  
Vol 86 (11) ◽  
pp. e4.82-e4
Author(s):  
Jeremy Cosgrove ◽  
Stuart Jamieson ◽  
Stephen Smith ◽  
Jane Alty
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Cognitive Assessment ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Montreal Cognitive Assessment ◽  
Visuospatial Ability ◽  
Clock Drawing ◽  
The Relationship ◽  
Normal Cognition

IntroductionClock drawing (CD) requires executive function, attention and visuospatial ability. Our objective was to investigate CD in Parkinson's subjects with and without cognitive impairment.Methods107 subjects completed the Montreal Cognitive Assessment (MoCA), classifying into normal cognition (PD-NC – MoCA ≥26) and cognitive impairment (PD-CI–MoCA <26). CD was scored using MoCA criteria; a maximum of 3 points, one each for correct contour, clock face and clock hands.ResultsPD-CI (n=57) and PD-NC were matched for all demographics except age (PD-CI were older, P 0.032). 35% of PD-CI scored full marks compared to 90% of PD-NC (sensitivity 0.64, specificity 0.9, age adjusted-odds ratio for predicting PD-CI 15.63, 95% CI 5.18 – 47.62, P<0.001). 88% of PD-CI scored points for contour and 60% scored points for clock face. In contrast, all PD-NC scored points for contour and clock face (P <0.001). 42% of PD-CI and 90% of PD-NC correctly drew clock hands (P<0.001).ConclusionsIn this cohort, inability to score maximum points for CD was associated with PD-CI. Correctly drawing clock hands was the hardest component for both groups. Incorrect contour or clock face was highly specific for PD-CI.

Validation of the Cuban Version of Addenbrooke’s Cognitive Examination-Revised for Screening Mild Cognitive Impairment

2017 ◽  
Vol 44 (5-6) ◽  
pp. 320-327 ◽  
Author(s):  
Yunier Broche-Pérez ◽  
Héctor Alejandro López-Pujol
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Operating Characteristic ◽  
Mini Mental State Examination ◽  
Screening Tool ◽  
Roc Curves ◽  
Elderly Subjects ◽  
Psychometric Scales ◽  
State Examination ◽  
Addenbrooke’S Cognitive Examination

Background/Aims: The diagnostic accuracy of the Cuban version of the revised Addenbrooke’s Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. Methods: The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen’s d) were calculated. Cronbach’s coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. Results: The Cuban ACE-R had reliable internal consistency (Cronbach’s coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. Conclusion: The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE.

The neurological examination adapted for neuropsychiatry

CNS Spectrums ◽  
2018 ◽  
Vol 23 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Sheldon Benjamin ◽  
Margo D. Lauterbach
Keyword(s):  
Neurological Examination ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tool ◽  
Rating Scale ◽  
Subcortical Structures ◽  
Dysmorphic Features ◽  
Examination Techniques ◽  
State Examination

The neuropsychiatric examination includes standard neurological and cognitive examination techniques with several additional observations and tasks designed to capture abnormalities common among patients with neuropsychiatric disorders or neurocognitive complaints. Although useful as a screening tool, a single standardized rating scale such as the Mini Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA) is insufficient to establish a neuropsychiatric diagnosis. Extra attention is paid to findings commonly seen in the setting of psychiatric disorders, dementias, movement disorders, or dysfunction of cortical or subcortical structures. Dysmorphic features, dermatologic findings, neurodevelopmental signs, signs of embellishment, and expanded neurocognitive testing are included. The neuropsychiatric clinician utilizes the techniques described in this article to adapt the examination to each patient’s situation, choosing the most appropriate techniques to supplement the basic neurological and psychiatric examinations in support of diagnostic hypotheses being considered. The added examination techniques facilitate diagnosis of neurocognitive disorders and enable neuropsychiatric formulation.

scholarly journals Montreal Cognitive Assessment scale in patients with Parkinson Disease with normal scores in the Mini-Mental State Examination

2019 ◽  
Vol 13 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Krisly Arguedas Vásquez ◽  
Erick Miranda Valverde ◽  
Daniel Valerio Aguilar ◽  
Henri-Jacques Hernández Gabarain
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Montreal Cognitive Assessment ◽  
Screening Tests ◽  
Study Results ◽  
State Examination

ABSTRACT. Several screening tests have been used for cognitive evaluation in Parkinson’s disease (PD). Objective: To evaluate the usefulness of the Montreal Cognitive Assessment (MoCA) in patients with Parkinson’s disease and no cognitive impairment complaints. Methods: A total of 40 PD patients with no complaints of cognitive problems were included. Patients were selected using the Mini-Mental State Examination (MMSE) and the MoCA was then administered. Results: 80% of patients exhibited Mild Cognitive Impairment (MCI) according to the MoCA. Statistically significant differences in visuospatial, attention and delayed recall functions were evident between the normal and abnormal MoCA groups. Conclusion: The study results suggest that MoCA may be a good screening test in patients with PD who do not present cognitive complaints.

Comparison between the accuracy of Montreal Cognitive Assessment and Mini-Mental State Examination in the detection of mild cognitive impairment

2021 ◽  
Author(s):  
Nayyereh Aminisani ◽  
Rasoul alimi ◽  
Ali Javadpour ◽  
Mohhamad Asghari-Jafarabadi ◽  
Mozhgan Jourian ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
The Impact ◽  
State Examination

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

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