Comparing face-to-face and videoconference completion of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke

2019 ◽  
pp. 1357633X1989078 ◽  
Author(s):  
Jodie E Chapman ◽  
Dominique A Cadilhac ◽  
Betina Gardner ◽  
Jennie Ponsford ◽  
Ruchi Bhalla ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Cognitive Assessment ◽  
Intraclass Correlation ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Community Based ◽  
Altman Plot ◽  
Bland Altman Plot ◽  
Face To Face

Introduction Videoconferencing may help address barriers associated with poor access to post-stroke cognitive screening. However, the equivalence of videoconference and face-to-face administrations of appropriate cognitive screening tools needs to be established. We compared face-to-face and videoconference administrations of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke. We also evaluated whether participant characteristics (e.g. age) influenced equivalence. Methods We used a randomised crossover design (two-week interval). Participants were recruited through community advertising and use of a stroke-specific database. Both sessions were conducted by the same researcher in the same location. Videoconference sessions were conducted using Zoom. A repeated-measures t-test, intraclass correlation coefficient (ICC), Bland–Altman plot and multivariate regression modelling were used to establish equivalence. Results Forty-eight participants (26 men, Mage = 64.6 years, standard deviation ( SD) = 10.1; Mtime since stroke = 5.2 years, SD = 4.0) completed the MoCA face-to-face and via videoconference on average 15.8 ( SD = 9.7) days apart. Participants did not perform systematically better in a particular condition, and no participant variable predicted difference in MoCA performance. However, the ICC was low (0.615), and the Bland–Altman plot indicated wide limits of agreement, indicating variability between sessions. Discussion Our findings provide preliminary evidence to support the use of videoconference to administer the MoCA following stroke. However, further research into the test–retest reliability of scores derived from the MoCA is needed in this population. Administering the MoCA via videoconference holds potential to ensure that all stroke survivors undergo cognitive screening, in line with recommended clinical practice.

Validation of the Sinhala Version of the Addenbrooke’s Cognitive Examination-Revised for the Detection of Dementia in Sri Lanka: Comparison with the Mini-Mental Status Examination and the Montreal Cognitive Assessment

2019 ◽  
Vol 47 (4-6) ◽  
pp. 198-208 ◽  
Author(s):  
Vindika Suriyakumara ◽  
Srinivasan  Srikanth ◽  
Ruwani  Wijeyekoon ◽  
Harsha  Gunasekara ◽  
Chanaka  Muthukuda ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Diagnostic Accuracy ◽  
Cognitive Assessment ◽  
Intraclass Correlation ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Cognitive Screening ◽  
Dementia Prevalence ◽  
Addenbrooke’S Cognitive Examination

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).

scholarly journals Converting from the Montreal Cognitive Assessment to the Mini-Mental State Examination-2

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254055
Author(s):  
Hwabeen Yang ◽  
Daehyuk Yim ◽  
Moon Ho Park
Keyword(s):  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Intraclass Correlation ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Conversion Table ◽  
Linear Smoothing ◽  
Log Linear ◽  
State Examination

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.

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.

C-03 The sensitivity and specificity of the Montreal Cognitive Assessment is Age Dependent for Amyloid Positivity in a Mixed Clinical Sample

2019 ◽  
Vol 34 (6) ◽  
pp. 1030-1030
Author(s):  
N Hawley ◽  
L Bennett ◽  
A Ritter
Keyword(s):  
Sensitivity And Specificity ◽  
Cognitive Assessment ◽  
Clinical Sample ◽  
Cleveland Clinic ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Amyloid Pet ◽  
Cognitive Screening ◽  
Positron Emission ◽  
Moca Score

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a widely-used screening tool for neurodegenerative disorders. Despite widespread use, there have been few investigations into correlations between MoCA and biomarkers of Alzheimer's disease pathology. This study examined the relationship between MoCA performance and the presence of amyloid as detected by positron emission tomography (PET). Methods Sensitivity and specificity for the total MoCA score were determined for 76 individuals (26 amyloid-negative, 50 amyloid- positive) who were between the ages of 55 and 90 and diagnosed with MCI or mild dementia with a CDR score of 0-1 and were participating in a longitudinal, observational study at the Cleveland Clinic Lou Ruvo Center for Brain Health. All individuals underwent an amyloid PET scan and cognitive screening. Results Sensitivity and specificity for the total score were determined using amyloid positivity as the standard. A cutpoint of 25 yielded the best balance between sensitivity and specificity (74% and 74%, respectively). A total score of 27 was required to achieve 90% sensitivity to identify amyloid positive individuals (i.e. only a 10% risk that individuals with a score of 28-30 have a positive scan). A score of 26 was required in individuals over the age of 75. Conclusions With the emergence of new diagnostic biomarkers, there is need to define the utility of affordable, widely-available screening tools. In this mixed clinical sample, the MoCA score showed good sensitivity for detecting amyloid pathology but with low specificity. Thus a total MoCA score of 28 is needed to confidently rule out risk for AD pathology.

Validation of the Kimberley Indigenous Cognitive Assessment short form (KICA-screen) for telehealth

2019 ◽  
pp. 1357633X1986030
Author(s):  
Sarah Russell ◽  
Rachel Quigley ◽  
Edward Strivens ◽  
Gavin Miller ◽  
Joan Norrie ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Torres Strait Islander ◽  
Short Form ◽  
Intraclass Correlation ◽  
Screening Tools ◽  
Culturally Appropriate ◽  
Face To Face ◽  
Dementia Screening ◽  
Increased Risk ◽  
Torres Strait

Introduction Studies show Aboriginal and Torres Strait Islander people are at increased risk of dementia. Whilst there have been several studies evaluating the use of telehealth for improving Aboriginal and Torres Strait Islander health outcomes, and studies validating telehealth dementia screening tools for the wider community, none have addressed the pressing need for culturally appropriate telehealth dementia screening for this at-risk population. The aim of the study was to examine the utility of using a culturally appropriate dementia screening tool (KICA-screen) in a telehealth setting. Methods A prospective field trial was used to compare administration of the short version of the Kimberley Indigenous Cognitive Assessment (KICA-screen) face-to-face and via telehealth. A total of 33 medically stable Aboriginal and Torres Strait Islander inpatients/outpatients participated. The stability of the KICA-screen scores, administered face-to-face and via telehealth, for each participant was measured. Results The two test delivery methods showed not only good correlation (Pearson’s r = 0.851; p < 0.01) but good agreement (intraclass correlation coefficient = 0.85; p < 0.01). Discussion Results of the assessment showed that KICA-screen can be reliably administered via videoconference and resulted in comparable scores to face-to-face testing in the majority of cases. The telehealth process was acceptable to participants, who were able to understand the process and complete the full screen via telehealth conditions.

Can MoCA and MMSE Be Interchangeable Cognitive Screening Tools? A Systematic Review

2018 ◽  
Vol 59 (6) ◽  
pp. e743-e763 ◽  
Author(s):  
Glória S A Siqueira ◽  
Paula de M S Hagemann ◽  
Daniela de S Coelho ◽  
Flávia Heloísa Dos Santos ◽  
Paulo H F Bertolucci
Keyword(s):  
Systematic Review ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Sensitive Tool ◽  
State Examination ◽  
Years Of Schooling

Abstract Background and Objectives Cognitive disorders may be an early sign of neuropsychiatric disorders; however, it remains unclear whether the screening measures are interchangeable. The aim of this study was to contrast the most commonly used screening tools—Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)—for early detection of neurocognitive disorder (NCD). Research Design and Methods This study presents a descriptive systematic review and informative literature according to the Cochrane Foundation’s guidelines. The keywords “Mini-Mental State Examination” and “Montreal Cognitive Assessment” were searched in the Web of Science, SciELO, and LILACS databases. Results Fifty-one studies were selected including a total sample of 11,870 participants (8,360 clinical patients and 3,510 healthy controls). Most studies were published in the past 5 years using a cross-sectional design, carried out across the world. They were organized by age ranges (18–69 years and 20–89 years), years of schooling, and mental status (with and without mental and behavior disorders). Sixteen of 18 studies had participants aged 18–69 years, and 21 out of 33 studies within the older set suggested that the MoCA is a more sensitive tool for detecting NCD. Discussion and Implications Thirty-seven studies suggested that the MoCA is a more sensitive tool for NCD detection because it assesses executive function and visuospatial abilities. Some individuals who demonstrated normal cognitive function on the MMSE had lower performance on the MoCA. However, it seems necessary to establish different cutoffs based on years of schooling to avoid false positives. Future studies should contrast MoCA with other screening tools designed for NCD assessment.

Montreal Cognitive Assessment and Mini-Mental Status Examination compared as cognitive screening tools in heart failure

Heart & Lung ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 521-529 ◽  
Author(s):  
Ponrathi Athilingam ◽  
Kathleen B. King ◽  
Scott W. Burgin ◽  
Michael Ackerman ◽  
Laura A. Cushman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mental Status ◽  
Cognitive Assessment ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Mini Mental Status Examination ◽  
Mental Status Examination

The Montreal Cognitive Assessment (MoCA) in geriatric rehabilitation: psychometric properties and association with rehabilitation outcomes

2011 ◽  
Vol 23 (10) ◽  
pp. 1582-1591 ◽  
Author(s):  
Lisa Sweet ◽  
Mike Van Adel ◽  
Valerie Metcalf ◽  
Lisa Wright ◽  
Anne Harley ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Rehabilitation Program ◽  
Cognitive Status ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Geriatric Rehabilitation ◽  
Cognitive Screening ◽  
Rehabilitation Outcome

ABSTRACTBackground:Cognitive status has been reported to be an important predictor of rehabilitation outcome. The Montreal Cognitive Assessment (MoCA) was designed to overcome some of the limitations of established cognitive screening tools such as the Mini-Mental State Examination (MMSE). The purpose of this study is to evaluate the psychometric characteristics of the MoCA as a screening tool in a geriatric rehabilitation program and its ability to predict rehabilitation outcome.Methods:Forty-seven geriatric rehabilitation program patients participated in the study. Assessments of each patient's functional (Functional Independence Measure) and cognitive status (MMSE and MoCA) were performed. Information on discharge destinations were obtained and rehabilitation efficacy and efficiency scores were calculated.Results:Significant correlations were found between the MoCA and other cognitive status measures. Cognitive status at admission and successful rehabilitation were also associated. Defining rehabilitation success on the basis of relative functional efficacy (an indicator that includes the patient's potential for improvement), the sensitivity and specificity of the MoCA were 80% and 30% respectively. The attention subscale of the MoCA was also uniquely predictive of rehabilitation success. The attention subscale (cutoff 5/6) of the MoCA had a sensitivity of 40% and specificity of 90%, as did the MMSE.Conclusions:As a cognitive screening tool, the MoCA appears to have acceptable psychometric properties. Results suggest that the MoCA can have a considerable advantage over the MMSE in sensitivity and equivalence in specificity using both total and attention scale scores. The MoCA may be a more useful measure for detecting cognitive impairment and predicting rehabilitation outcome in this population.

Comparing Performance Across In-person and Videoconference-Based Administrations of Common Neuropsychological Measures in Community-Based Survivors of Stroke

2020 ◽  
pp. 1-14
Author(s):  
Jodie E. Chapman ◽  
Betina Gardner ◽  
Jennie Ponsford ◽  
Dominique A. Cadilhac ◽  
Renerus J. Stolwyk
Keyword(s):  
Neuropsychological Assessment ◽  
Language Impairment ◽  
Repeated Measures ◽  
Verbal Learning ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Preliminary Evidence ◽  
Service Access ◽  
Community Based ◽  
Neuropsychological Measures

Abstract Objective: Neuropsychological assessment via videoconference could assist in bridging service access gaps due to geographical, mobility, or infection control barriers. We aimed to compare performances on neuropsychological measures across in-person and videoconference-based administrations in community-based survivors of stroke. Method: Participants were recruited through a stroke-specific database and community advertising. Stroke survivors were eligible if they had no upcoming neuropsychological assessment, concurrent neurological and/or major psychiatric diagnoses, and/or sensory, motor, or language impairment that would preclude standardised assessment. Thirteen neuropsychological measures were administered in-person and via videoconference in a randomised crossover design (2-week interval). Videoconference calls were established between two laptop computers, facilitated by Zoom. Repeated-measures t tests, intraclass correlation coefficients (ICCs), and Bland–Altman plots were used to compare performance across conditions. Results: Forty-eight participants (26 men; M age = 64.6, SD = 10.1; M time since stroke = 5.2 years, SD = 4.0) completed both sessions on average 15.8 (SD = 9.7) days apart. For most measures, the participants did not perform systematically better in a particular condition, indicating agreement between administration methods. However, on the Hopkins Verbal Learning Test – Revised, participants performed poorer in the videoconference condition (Total Recall Mdifference = −2.11). ICC estimates ranged from .40 to .96 across measures. Conclusions: This study provides preliminary evidence that in-person and videoconference assessment result in comparable scores for most neuropsychological tests evaluated in mildly impaired community-based survivors of stroke. This preliminary evidence supports teleneuropsychological assessment to address service gaps in stroke rehabilitation; however, further research is needed in more diverse stroke samples.

Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

2021 ◽  
pp. 089198872110026
Author(s):  
Sivan Klil-Drori ◽  
Natalie Phillips ◽  
Alita Fernandez ◽  
Shelley Solomon ◽  
Adi J. Klil-Drori ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Cross Sectional Study ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
A Prospective Study ◽  
Sectional Analysis ◽  
State Examination ◽  
Normal Cognition

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.

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