scholarly journals Sensitivity and specificity of the Brazilian version of the Montreal Cognitive Assessment – Basic (MoCA-B) in chronic kidney disease

2019 ◽  
Vol 41 (4) ◽  
pp. 327-333
Author(s):  
Thaís Malucelli Amatneeks ◽  
Amer Cavalheiro Hamdan
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Sensitivity And Specificity ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Specificity And Sensitivity ◽  
Starting Point

Abstract Introduction Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. Objective To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment – Basic (MoCA-B) for identification of cognitive impairment in the CKD population. Methods This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. Results The MoCA-B has reliable internal consistency (Cronbach’s alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. Conclusions The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.

scholarly journals Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

2019 ◽  
Vol 41 (1) ◽  
pp. 112-123 ◽  
Author(s):  
Thaís Malucelli Amatneeks ◽  
Amer Cavalheiro Hamdan
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Treatment Modalities ◽  
Cross Sectional ◽  
Application Profile ◽  
Made In

Abstract Introduction: There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD. Method: The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English. Results: The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies. Discussion: The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients. Conclusions: The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.

scholarly journals Montreal Cognitive Assessment (MoCA) screening mild cognitive impairment in patients with chronic kidney disease (CKD) pre-dialysis

2016 ◽  
Vol 38 (1) ◽  
Author(s):  
Marilise de Andrade Paraizo ◽  
Ana Laura Maciel Almeida ◽  
Leopoldo Antônio Pires ◽  
Renata Silva Almeida Abrita ◽  
Mary Hellen Teixeira Crivellari ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment

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.

scholarly journals Normal-tension glaucoma is associated with cognitive impairment

2021 ◽  
pp. bjophthalmol-2020-317461
Author(s):  
Sean Mullany ◽  
Lewis Xiao ◽  
Ayub Qassim ◽  
Henry Marshall ◽  
Puya Gharahkhani ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Vision Loss ◽  
Linear Trend ◽  
Normal Tension Glaucoma ◽  
Cognitive Screening ◽  
Visual Interpretation ◽  
Cross Sectional ◽  
High Tension ◽  
Advanced Glaucoma

Background/aimsRecent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry.MethodsThe authors completed a case–control cross-sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores.ResultsA total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108).ConclusionThis study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.

Everyday Technology Use and Overall Needed Assistance to Function in the Home and Community Among Urban Older Adults

2019 ◽  
Vol 39 (10) ◽  
pp. 1115-1123 ◽  
Author(s):  
Ryan J. Walsh ◽  
Jenica Lee ◽  
Ruxandra M. Drasga ◽  
Caniece S. Leggett ◽  
Holly M. Shapnick ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Cognitive Assessment ◽  
High Specificity ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Community Activities ◽  
Specificity And Sensitivity ◽  
The Everyday

Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.

Short Montreal Cognitive Assessment

2016 ◽  
Vol 30 (2) ◽  
pp. 104-108 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Computerized Adaptive Testing ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Subjective Memory ◽  
Index Study ◽  
Diagnosis Of Dementia

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.

Cognitive Impairment in Advanced Chronic Kidney Disease: The Canadian Frailty Observation and Interventions Trial

2016 ◽  
Vol 44 (6) ◽  
pp. 473-480 ◽  
Author(s):  
Rukhsana Foster ◽  
Simon Walker ◽  
Ranveer Brar ◽  
Brett Hiebert ◽  
Paul Komenda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
High Rate ◽  
Control Group ◽  
Cross Sectional ◽  
History Of ◽  
Poor Nutrition

Background: Chronic kidney disease (CKD) affects more than one third of older adults, and is a strong risk factor for vascular disease and cognitive impairment. Cognitive impairment can have detrimental effects on the quality of life through decreased treatment adherence and poor nutrition and results in increased costs of care and early mortality. Though widely studied in hemodialysis populations, little is known about cognitive impairment in patients with pre-dialysis CKD. Methods: Multicenter, cross-sectional, prospective cohort study including 385 patients with CKD stages G4-G5. Cognitive function was measured with a validated tool called the Montreal Cognitive Assessment (MoCA) as part of a comprehensive frailty assessment in the Canadian Frailty Observation and Interventions Trial. Cognitive impairment was defined as a MoCA score of ≤24. We determined the prevalence and risk factors for cognitive impairment in patients with CKD stages G4-G5, not on dialysis. Results: Two hundred and thirty seven participants (61%) with CKD stages G4-G5 had cognitive impairment at baseline assessment. When compared to a control group, this population scored lower in all domains of cognition, with the most pronounced deficits observed in recall, attention, and visual/executive function (p < 0.01 for all comparisons). Older age, recent history of falls and history of stroke were independently associated with cognitive impairment. Conclusions: Our study uncovered a high rate of unrecognized cognitive impairment in an advanced CKD population. This impairment is global, affecting all aspects of cognition and is likely vascular in nature. The longitudinal trajectory of cognitive function and its effect on dialysis decision-making and outcomes deserves further study.

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