scholarly journals Validating a Pragmatic Approach to Cognitive Screening in Stroke Prevention Clinics Using the Montreal Cognitive Assessment

Stroke ◽  
2016 ◽  
Vol 47 (3) ◽  
pp. 807-813 ◽  
Author(s):  
Richard H. Swartz ◽  
Megan L. Cayley ◽  
Krista L. Lanctôt ◽  
Brian J. Murray ◽  
Eric E. Smith ◽  
...  
2021 ◽  
pp. 089198872110026
Author(s):  
Sivan Klil-Drori ◽  
Natalie Phillips ◽  
Alita Fernandez ◽  
Shelley Solomon ◽  
Adi J. Klil-Drori ◽  
...  

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.


2019 ◽  
Vol 47 (4-6) ◽  
pp. 198-208 ◽  
Author(s):  
Vindika Suriyakumara ◽  
Srinivasan  Srikanth ◽  
Ruwani  Wijeyekoon ◽  
Harsha  Gunasekara ◽  
Chanaka  Muthukuda ◽  
...  

Background: Sri Lanka is a rapidly aging country, where dementia prevalence will increase significantly in the future. Thus, inexpensive and sensitive cognitive screening tools are crucial. Objectives: To assess the reliability, validity, and diagnostic accuracy of the Sinhalese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R s). Method: The ACE-R was translated into Sinhala with cultural and linguistic adaptations and administered, together with the Sinhala version of the Montreal Cognitive Assessment (MoCA), to 99 patients with dementia and 93 gender-matched controls. Results: The ACE-R s cutoff score for dementia was 80 (sensitivity 91.9%, specificity 76.3%). The areas under the curve for the ACE-R s, Mini-Mental State Examination (MMSE) and MoCA were 0.90, 0.86, and 0.86, respectively. The ­ACE-R s had good interrater reliability (intraclass correlation = 0.94), test-retest reliability (intraclass correlation = 0.99), and internal consistency (Cronbach’s α = 0.8442). Conclusions: The ACE-R s is sensitive, specific and reliable to detect dementia in persons aged ≥50 years in a Sinhala-speaking population and its diagnostic accuracy is superior to previously validated tools (MMSE and MoCA).


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Larisa Shehaj ◽  
Merita Rroji (Molla)

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.


2016 ◽  
Vol 30 (2) ◽  
pp. 104-108 ◽  
Author(s):  
A. J. Larner

The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.


2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 468-468 ◽  
Author(s):  
C. Brymer ◽  
C. Sider ◽  
A. Evans ◽  
B.Y. Lee ◽  
K. Taneja ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254055
Author(s):  
Hwabeen Yang ◽  
Daehyuk Yim ◽  
Moon Ho Park

Objective The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination-2 (MMSE-2) are useful psychometric tests for cognitive screening. Many clinicians want to predict the MMSE-2 score based on the MoCA score. To facilitate the transition from the MoCA to the MMSE-2, this study developed a conversion method. Methods This study retrospectively examined the relationship between the MoCA and MMSE-2. Overall, 303 participants were evaluated. We produced a conversion table using the equipercentile equating method with log-linear smoothing. Then, we evaluated the reliability and accuracy of this algorithm to convert the MoCA to the MMSE-2. Results MoCA scores were converted to MMSE-2 scores according to a conversion table that achieved a reliability of 0.961 (intraclass correlation). The accuracy of this algorithm was 84.5% within 3 points difference from the raw score. Conclusions This study reports a reliable and easy conversion algorithm for transforming MoCA scores into converted MMSE-2 scores. This method will greatly enhance the utility of existing cognitive data in clinical and research settings.


2021 ◽  
pp. 78-84
Author(s):  
Valmir Vicente Filho ◽  
Carolina Ayumi Ichi ◽  
Paulo Henrique Ferreira Bertolucci ◽  
Mauren Carneiro da Silva Rubert ◽  
Viviane de Hiroki Flumignan Zétola

Introduction: Montreal Cognitive Assessment (MoCA) is the most common cognitive screening instrument for Mild Cognitive Impairment detection. Although the current Brazilian version (MoCA-BR) has been validated, in clinical practice, it is observed that adults with normal cognitive function, especially those less educated, rarely reaches the maximum score of 30 points on the test. Objective: Introduce a methodology to adjust the Brazilian version according to the Brazilian culture. A cross-se Methods: ctional observational study was conducted with 294 participants. In the Memory section, we used the free listing technique to replace words. In the Naming section, an epidemiological survey of the most pinpointed gures was conducted. Replication of Sentence section was modied based on meetings between researchers and Portuguese teachers uent in English. The alternative version of MoCA-BR was composed by: "az Results: ul" (blue), "braço" (arm), "orquídea" (orchid), "seda" (silk) and “igreja” (church) in Memory Section; giraffe, elephant, and lion in the Naming section; “Eu só sei que é João quem será ajudado hoje” and "O gato sempre se esconde embaixo do sofá quando o cachorro está na sala" in the Replication of Sentence section. Our Conclusions: data reinforce the need to adapt the MoCA-BR. We present an alternative version of MoCA-BR, which contemplates the linguistic and cultural requirements of the transcultural adaptation process. The next step is to apply this version to obtain its validation. We believe that this adaptation may allow a future better applicability of the MoCA-BR, especially in less educated people, without underestimating the scores of cognitively normal individuals


2020 ◽  
Vol 35 (6) ◽  
pp. 811-811
Author(s):  
Ratcliffe L ◽  
Marker C

Abstract The Montreal Cognitive Assessment (MoCA) is considered to be a suitable, sensitive, and specific cognitive screening tool for detecting mild cognitive impairment. Research has reported variable cutoff scores for the MoCA based upon geographical location. The aim of the present study is to provide normative data in a sample of cognitively healthy adults. Data was collected through the National Alzheimer’s Coordinating Center (NACC). A population of healthy adults (N = 3610) was examined (66% female, 78% Caucasian, 16% African American, 6% Other). MoCA normative data were derived from age and education, which were found to be weakly but significantly associated with age (r = −.203, p = .000) and more strongly correlated with education (r = .402, p = .000). Total scores (M = 26.25, SD = 2.75) were at the suggested cutoff for impairment (&lt; 26). Based on an ANOVA, age had a significant effect on MoCA scores (F (6, 3603) = 25.30, p &lt; .001). A second ANOVA revealed that education also had a significant effect on MoCA scores (F (2, 3582) = 290.56, p &lt; .001). Individuals with higher levels of education obtained higher MoCA scores. Performance was also found to decrease slightly with age. Therefore, clinicians should use caution when applying the recommended cutoff scores.


Author(s):  
Chantel Teresa Debert ◽  
Joan Stilling ◽  
Meng Wang ◽  
Tolulope Sajobi ◽  
Kristina Kowalski ◽  
...  

ABSTRACT:Background: The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool known to accurately measure mild cognitive impairment (MCI) in many different neurological populations. Objective: We aimed to determine whether a sport-related concussion (SRC) history and other concussion modifiers influence global cognitive function in high-performance athletes. Methods: A cross-sectional study of 326 varsity and national team athletes aged 18–36 years was completed at the University of Calgary Sports Medicine Clinic, Calgary, Alberta, Canada. Logistic regression analysis was used to examine the association between the total MoCA score, MoCA subscales, and number of previous SRC, adjusting for age, sex, sport participation (SP), and concussion modifiers. Results: Athletes with a history of three or more SRC were 5.36 times more likely to score less than 26/30 on the MoCA (the cutoff for MCI) compared to athletes with two or less SRC (p = 0.02). Males were 2.23 times more likely to have MCI than females (p = 0.0004). There was a significant relationship between the number of previous concussions and the MoCA subscales of attention (p = 0.05) and abstraction (p = 0.003). Age, SP, and concussion modifiers (migraine, depression, anxiety, and attention deficit and hyperactivity disorder) did not influence the relationship between MoCA and previous concussion history. Conclusion: In the appropriate clinical context, cognitive screening with the MoCA may benefit clinical care in athletes with multiple previous SRC, but should not replace a full neuropsychological assessment. Thus, further research is needed to compare the MoCA to full neuropsychological assessments in this population.


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