Utility of Montreal Cognitive Assessment in Differentiating Dementia With Lewy Bodies From Alzheimer’s Dementia

2017 ◽  
Vol 32 (8) ◽  
pp. 468-471 ◽  
Author(s):  
Erin Yamamoto ◽  
Lyla Mourany ◽  
Rosemary Colleran ◽  
Christine Whitman ◽  
Babak Tousi

Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) are the 2 most common neurodegenerative dementias. Identification of patients with DLB is necessary to guide appropriate clinical management and medication trials. Patients with DLB are reported to perform poorly on tasks of visuospatial and executive function, compared to patients with AD who perform poorly on memory tasks. Using the Montreal Cognitive Assessment, we found that patients with DLB (n = 73) had statistically significant lower performance in clock drawing (visuospatial and executive function) and higher performance in delayed recall (memory) subscores compared to patients with AD (n = 57). This score pattern should raise suspicion for a DLB diagnosis at initial evaluation of patients with dementia.

2015 ◽  
Vol 86 (11) ◽  
pp. e4.82-e4
Author(s):  
Jeremy Cosgrove ◽  
Stuart Jamieson ◽  
Stephen Smith ◽  
Jane Alty

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.


2013 ◽  
Vol 25 (11) ◽  
pp. 1839-1848 ◽  
Author(s):  
Carol Sheei-Meei Wang ◽  
Ming-Chyi Pai ◽  
Pai-Lien Chen ◽  
Nien-Tsen Hou ◽  
Pei-Fang Chien ◽  
...  

ABSTRACTBackground:The aim of this study was to examine and test the sensitivity, specificity, and threshold scores of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) and determine those that best correspond to a clinical diagnosis of dementia with Lewy bodies (DLB).Methods:Sixty-seven Alzheimer's disease (AD), 36 DLB, and 62 healthy participants without dementia (NC), aged 60 to 90, were enrolled. All three groups took the MoCA and MMSE tests at the same time. The Cochran–Mantel–Haenszel tests and receiver operating characteristics curve analysis were used to compare the different neuropsychological test results among the groups.Results:The cut-off point of the MoCA for AD was 21/22 with a sensitivity of 95.5% and a specificity of 82.3% (area under the curve (AUC): 0.945), and the cut-off point for DLB was 22/23 with a sensitivity of 91.7% and a specificity of 80.6% (AUC: 0.932). For the MMSE, the cut-off points for AD and for DLB from NC were all 24/25, with a sensitivity of 88.1% and a specificity of 85.5% for AD (AUC: 0.92), and a sensitivity of 77.8% and a specificity of 85.5% for DLB (AUC: 0.895). After controlling sex, age, and education, AD and DLB had lower scores in all MoCA subscales than the NC group (p < 0.05), except for the orientation and naming in DLB. In addition, AD had a lower score in the MoCA orientation (p = 0.03) and short-term memory (p = 0.02) than did DLB.Conclusions:The MoCA is a more sensitive instrument than the MMSE to screen AD or DLB patients from non-dementia cases.


2019 ◽  
Vol 77 (1) ◽  
pp. 19-24
Author(s):  
Ozlem Balbaloglu ◽  
Nermin Tanık

ABSTRACT Aim: Our aim was to determine whether there is a relationship between vitamin D [25(OH)D] and cognitive functioning in women with low 25(OH)D levels. Methods: Ninety female patients, 25-45 years of age, who attended our outpatient clinic and had 25(OH)D levels < 30 ng/mL, were included. The Montreal Cognitive Assessment (MoCA) scale was used to determine cognitive functioning; the scale is divided into seven subgroups. Patients were divided into three subgroups according to their 25(OH)D levels. After a three-month period of 25(OH) D replacement, the patients underwent a re-evaluation using the MoCA scale. Results: The total MoCA score before treatment was significantly different from the score after treatment (p < 0.05). Language and delayed recall functions were significantly different before and after treatment (p < 0.05). Conclusion: Vitamin D levels were related to cognitive functioning in our study group.


2019 ◽  
Author(s):  
Yan-rong Zhang ◽  
Yun-Long Ding ◽  
Ke-liang Chen ◽  
Yan Liu ◽  
Can Wei ◽  
...  

Abstract Background To determine whether items of the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) could discriminate among cognitively normal controls (NC), and those with mild cognitive impairment (MCI), mild Alzheimer’s disease (AD), and moderate-severe (AD), as well as their sensitivity and specificity.Methods MCI (n=456), mild AD (n=502) and moderate-severe AD (n=102) patients were recruited from the memory clinic, Huashan Hospital, Shanghai, China. NC (n=329) were recruited from health checkup outpatients. Five MoCA-BC item scores were collected in interviews.Results The MoCA-BC orientation test had high sensitivity and specificity for discrimination among MCI, mild AD and moderate-severe AD. The delayed recall memory test had high sensitivity and specificity for MCI screening. The verbal fluency test was efficient for detecting MCI and differentiating AD severity.Conclusions Various items of the MoCA-BC can identify MCI patients early and identify the severity of dementia.


2019 ◽  
Author(s):  
Yan-rong Zhang ◽  
Yun-Long Ding ◽  
Ke-liang Chen ◽  
Yan Liu ◽  
Can Wei ◽  
...  

Abstract Background To determine whether items of the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) could discriminate among cognitively normal controls (NC), and those with mild cognitive impairment (MCI), mild Alzheimer’s disease (AD), and moderate-severe (AD). Methods MCI (n=456), mild AD (n=502) and moderate-severe AD (n=102) patients were recruited from the memory clinic, Huashan Hospital, Shanghai, China. NC (n=329) were recruited from health checkup outpatients. Five MoCA-BC item scores were collected in interviews. Results The MoCA-BC orientation test had high sensitivity and specificity for discrimination among MCI, mild AD and moderate-severe AD. The delay recall memory test had high sensitivity and specificity for MCI screening. The verbal fluency test was efficient for detecting MCI and differentiating AD severity. Conclusions Various items of the MoCA-BC can identify MCI patients early and identify the severity of dementia.


2021 ◽  
pp. 1-10
Author(s):  
Hemant Srivastava ◽  
Allen Joop ◽  
Raima A. Memon ◽  
Jennifer Pilkington ◽  
Kimberly H. Wood ◽  
...  

Background: Cognitive impairment is common and disabling in Parkinson’s disease (PD). Cognitive testing can be time consuming in the clinical setting. One rapid test to detect cognitive impairment in non-PD populations is the Clock Drawing Test (CDT), which calls upon the brain’s executive and visuospatial abilities to draw a clock designating a certain time. Objective: Test the hypothesis that PD participants would perform worse on CDT compared to controls and that CDT would correlate with other measures of cognition. Methods: This study evaluated two independent CDT scoring systems and differences in CDT performance between PD (N = 97) and control (N = 54) participants using a two-sample t-test. Pearson’s correlations were conducted between the CDT and tests of sleepiness (Epworth Sleepiness Scale) and vigilance (Psychomotor Vigilance Test); executive function (Trails B-A); and global cognition (Montreal Cognitive Assessment). Receiver operating characteristic curves were used to determine cut points on the CDT that identify individuals who need additional cognitive testing. Results: PD participants had worse performance on CDT compared to controls. The CDT was correlated with executive function (Trails B-A) and global cognition (Montreal Cognitive Assessment). The CDT correlated with vigilance (Psychomotor Vigilance Task) only in healthy controls. However, the CDT was not correlated with measures of sleepiness (Epworth Sleepiness Scale) in either group. A cut point of 9 on the Rouleau scale and 18 on the Mendez scale identified PD participants with cognitive impairment. Conclusion: The CDT is a rapid clinical cognitive assessment that is feasible in PD and correlates with other measures of cognition.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Safira Anjalia ◽  
Paulus Anam Ong ◽  
Nur Atik ◽  
Laniyati Hamijoyo

Background: The involvement of neuropsychiatry is reported in 6% to 91% of Systemic Lupus Erythematosus (SLE) patients. It can cause fatal morbidity and mortality. Memory impairment is one of the most common symptoms of neuropsychiatry involvement. This study aims to find out the performance of memory test in SLE patients using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina).Method: This cross sectional study recruited 30 SLE patients. Cognitive abilities and patient’s memory were examined using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina). Cognitive impairment was determined when total MoCA-Ina score was below 26. For memory evaluation, immediate recall or delayed recall impairment was determined when the patient failed in each memory subtests.Results: The mean of total MoCA-Ina score was 24.97 (SD±3.14). Fifty percent of the SLE patients had cognitive impairment, with the domain involved being delayed recall (86.67%), attention (60%), language (56.67%), abstraction (53.33%), and visuo-spatial/ executive function (36.67%). Most patients (86.67%) could completely repeat immediate recall. Whileonly 4 (13.33%) subjects could repeat delayed recall completely without any clue. Of the 26 SLE patients who failed to recall completely, 24 (92.3%) of them succeeded to recall completely after getting clue(s).Conclusion: Memory impairment is the most frequent cognitive impairment in SLE patients, especially in delayed recall. By using the memory subtests of MoCAIna, more than four fifth of patients with SLE was detected having delayed recall memory impairment and almost all of them could recalled completely after getting clue(s). This findings indicated that the finalstep of memory process retrieval in SLE was interrupted while being encoded, but retention pathway were stillintact.Keywords: Systemic Lupus Erythematous, Memory, MoCA-Ina


Sign in / Sign up

Export Citation Format

Share Document