Impaired cognitive performance on MoCA testing at discharge in elderly patients following day endoscopy and its relationship to preoperative mild cognitive impairment

2021 ◽  
pp. 0310057X2199745
Author(s):  
Nathan J Chua ◽  
Georgia Dimopoulos ◽  
David A Scott ◽  
Brendan S Silbert ◽  
Lisbeth A Evered
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Montreal Cognitive Assessment ◽  
Confusion Assessment ◽  
Diagnostic Confusion

In patients admitted to hospital, preoperative mild cognitive impairment predicts postoperative complications. The effect of mild cognitive impairment on discharge readiness among the day stay surgery population is unknown. Our aims were to determine the incidence of impaired cognitive performance at discharge after day stay endoscopy and whether pre-existing mild cognitive impairment was associated with its development. A single-centre cohort study of elective day stay endoscopy patients was undertaken. Over a three-month period, data were collected from 69 patients aged 65 years and over. Patients were cognitively assessed on admission and discharge using the Montreal cognitive assessment tool and the three-minute diagnostic confusion assessment method. At baseline, patients who scored 1.5 or more standard deviations below age-adjusted levels on the Montreal cognitive assessment tool in conjunction with a subjective memory complaint were classified as having mild cognitive impairment. At discharge, patients were classified as having impaired cognitive performance if there was a reduction in the Montreal cognitive assessment tool score by at least two points. We also assessed delirium and subsyndromal delirium at discharge using the three-minute diagnostic confusion assessment method. We identified mild cognitive impairment in 23 patients (33.3%) on admission, and impaired performance on the Montreal cognitive assessment tool test at discharge in 35 (50.7%) patients. There was no association between mild cognitive impairment on admission and impaired cognitive performance at discharge (50.0% versus 51.1%, P = 0.94). This study demonstrates that evidence of impaired cognitive performance on the Montreal cognitive assessment tool testing is present after day stay endoscopy in over 50% of elderly patients, but this is not associated with preoperative cognitive status.

Use of the Montreal Cognitive Assessment Thai Version to Discriminate Amnestic Mild Cognitive Impairment from Alzheimer’s Disease and Healthy Controls: Machine Learning Results

2021 ◽  
pp. 1-12
Author(s):  
Solaphat Hemrungrojn ◽  
Sookjaroen Tangwongchai ◽  
Thammanard Charoenboon ◽  
Muthita Panasawat ◽  
Thitiporn Supasitthumrong ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Roc Curve ◽  
Cognitive Assessment ◽  
Assessment Tool ◽  
Amnestic Mild Cognitive Impairment ◽  
Montreal Cognitive Assessment ◽  
Healthy Controls

<b><i>Background:</i></b> The Montreal Cognitive Assessment (MoCA) is an effective and applicable screening instrument to confirm the diagnosis of amnestic mild cognitive impairment (aMCI) from patients with Alzheimer’s disease (AD) and healthy controls (HCs). <b><i>Objectives:</i></b> This study aimed to determine the reliability and validity of the following: (a) Thai translation of the MoCA (MoCA-Thai) and (b) delineate the key features of aMCI based on the MoCA subdomains. <b><i>Methods:</i></b> This study included 60 HCs, 61 aMCI patients, and 60 AD patients. The MoCA-Thai shows adequate psychometric properties including internal consistency, concurrent validity, test-retest validity, and inter-rater reliability. <b><i>Results:</i></b> The MoCA-Thai may be employed as a diagnostic criterion to make the diagnosis of aMCI, whereby aMCI patients are discriminated from HC with an area under the receiver-operating characteristic (AUC-ROC) curve of 0.813 and from AD patients with an AUC-ROC curve of 0.938. The best cutoff scores of the MoCA-Thai to discriminate aMCI from HC is ≤24 and from AD &#x3e; 16. Neural network analysis showed that (a) aberrations in recall was the most important feature of aMCI versus HC with impairments in language and orientation being the second and third most important features and (b) aberrations in visuospatial skills and executive functions were the most important features of AD versus aMCI and that impairments in recall, language, and orientation but not attention, concentration, and working memory, further discriminated AD from aMCI. <b><i>Conclusions:</i></b> The MoCA-Thai is an appropriate cognitive assessment tool to be used in the Thai population for the diagnosis of aMCI and AD.

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.

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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