Montreal cognitive assessment in Brazilian adults with sickle cell disease: The burdens of poor sociocultural background
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SUBMITTER: Junqueira Fleury Silva P
PROVIDER: S-EPMC11020111 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe Montreal Cognitive Assessment (MoCA) is known to have discriminative power for patients with Mild Cognitive Impairment (MCI). Recently Cognitive Reserve (CR) has been introduced as a factor that compensates cognitive decline. We aimed to assess whether the MoCA reflects CR. Furthermore, we assessed whether there were any differences in the efficacy between the MoCA and the Mini-Mental State Examination (MMSE) in reflecting CR.MethodsMoCA, MMSE, and the Cognitive Reserve Index questionnaire (CRIq) were administered to 221 healthy participants. Normative data and associated factors of the MoCA were identified. Correlation and regression analyses of the MoCA, MMSE and CRIq scores were performed, and the MoCA score was compared with the MMSE score to evaluate the degree to which the MoCA reflected CR.ResultsThe MoCA reflected total CRIq score (CRI; B = 0.076, P < 0.001), CRI-Education (B = 0.066, P < 0.001), and CRI-Working activity (B = 0.025, P = 0.042), while MMSE reflected total CRI (B = 0.044, P < 0.001) and CRI-Education (B = 0.049, P < 0.001) only. The MoCA differed from the MMSE in the reflection of total CRI (Z = 2.30).ConclusionIn this study, we show that the MoCA score reflects CR more sensitively than the MMSE score. Therefore, we suggest that MoCA can be used to assess CR and early cognitive decline.
| S-EPMC6208087 | biostudies-literature
Project description:ObjectiveThe Montreal Cognitive Assessment (MoCA) is a brief screening instrument for detecting mild cognitive dysfunction, a precursor to many cognitive disorders, such as dementia, which have increased in prevalence globally. Qatar, a small high-income country, has the largest projected increase in dementia of any country in the Middle East. Yet no population-based norms for cognitive function are available to date.MethodsAs part of the first national cross-sectional study of mental health, a total of 395 Qatari and non-Qatari Arabs, 18-74 years of age, were evaluated face-to-face using the Arabic version of the original MoCA (version 7.1). We computed raw and demographically (gender, age in years, and four education categories) adjusted scores for the overall MoCA test and six domains (visuospatial, executive function, attention, language, delayed memory, and orientation). The percentile ranking of raw and adjusted normative (z) scores was computed. The 5th percentile ranking was used to derive potential cut-offs for the overall test and the six related domains.ResultsFemale gender, older age, and lower levels of education were associated with poorer overall test scores. The following MoCA overall test and domains cut-off scores (rounded to the nearest integer) were identified: MoCA (22), visuospatial (2), executive (2.5), attention (4), language (4), and delayed memory (3).ConclusionsOn the basis of our population-based data, scores below these 5th percentile cut-offs may warrant further testing and clinical follow-up for mild cognitive impairment (MCI) in otherwise healthy Arab adults.
| S-EPMC11807847 | biostudies-literature
Project description:IntroductionThere 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.MethodThe 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.ResultsThe 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.DiscussionThe 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.ConclusionsThe 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.
| S-EPMC6534019 | biostudies-literature
Project description:ObjectivesThe primary objective of the current study is to describe the prevalence and profile of cognitive domains affected in older adults with hematological malignancies evaluated for hematopoietic cell transplantation (HCT) using the Montreal Cognitive Assessment (MoCA) and neuropsychological tests. The secondary objective is to determine if a specific MoCA cut-off score would correlate with the identification of cognitive impairment detected by neuropsychological tests. This would facilitate interpretation of cognitive screening and referral of patients who would likely need further neuropsychological testing.Materials and methodsFifty-one patients 60 years and older who were evaluated for HCT were assessed using a battery of standardized neuropsychological tests and MoCA. We analyzed Receiver Operating Characteristics (ROC) comparing MoCA scores and four different neuropsychological test criteria for cognitive impairment.ResultsThe prevalence of cognitive impairment detected by neuropsychological tests was 53 to 70.6% using the criteria for patients with cancer by the International Cancer Cognition Task Force (ICCTF). The following cognitive domains were most affected: language, learning and memory, visuospatial skills, and executive function. MoCA is an appropriate screening test for cognitive impairment. Using the ICCTF criteria, 86 to 100% of patients are correctly classified as having significant cognitive impairment on neuropsychological tests using a cut-off score of 20 or less.ConclusionThere is a high prevalence of cognitive impairment identified by neuropsychological tests in older patients with hematological malignancies evaluated for HCT. Identification of an appropriate MoCA cut-off score in this population is important to identify patients who would benefit from further assessment.
| S-EPMC7054178 | biostudies-literature
Project description:Background/objectivesAssessment of cognition in linguistically diverse aging populations is a growing need. Bilingualism may complicate cognitive measurement precision, and bilingualism may vary across Hispanic/Latinx sub-populations. We examined the association among bilingualism, assessment language, and cognitive screening performance in a primarily non-immigrant Mexican American community.DesignProspective, community-based cohort study: The Brain Attack Surveillance in Corpus Christi (BASIC)-Cognitive study.SettingNueces County, Texas.ParticipantsCommunity-dwelling Mexican Americans age 65+, recruited door-to-door using a two-stage area probability sampling procedure.MeasurementsMontreal Cognitive Assessment (MoCA); self-reported bilingualism scale. Participants were classified as monolingual, Spanish dominant bilingual, English dominant bilingual, or balanced bilingual based upon bilingualism scale responses. Linear regressions examined relationships among bilingualism, demographics, cognitive assessment language, and MoCA scores.ResultsThe analytic sample included 547 Mexican American participants (60% female). Fifty-eight percent were classified as balanced bilingual, the majority (88.6%) of whom selected assessment in English. Balanced bilinguals that completed the MoCA in English performed better than balanced bilinguals that completed the MoCA in Spanish (b = -4.0, p < 0.05). Among balanced bilinguals that took the MoCA in Spanish, education outside of the United States was associated with better performance (b = 4.4, p < 0.001). Adjusting for demographics and education, we found no association between the degree of bilingualism and MoCA performance (p's > 0.10).ConclusionBilingualism is important to consider in cognitive aging studies in linguistically diverse communities. Future research should examine whether cognitive test language selection affects cognitive measurement precision in balanced bilinguals.
| S-EPMC8273138 | biostudies-literature
Project description:BackgroundThe Montreal Cognitive assessment (MoCA) is a well-validated global cognitive screening instrument. Its validity in progressive supranuclear palsy (PSP) has not been assessed.ObjectivesTo evaluate the MoCA as an outcome measure in PSP clinical trials.MethodsCognitive data from 162 participants in the placebo arm of the Biogen PASSPORT study (NCT03068468) were analyzed using linear mixed-effects modeling (LMM) and repeated measures correlation.ResultsThere was a significant decline in the MoCA score over time of -1.4 (95% CI -0.84 to -1.97) points over a 48-week period (p < 0.0001). Small but significant changes (p < 0.01) were observed in all MoCA domains except abstraction. The MoCA correlated weakly with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) over time (r rm = 0.1, p = 0.02) but exhibited a stronger correlation with the PSP Rating Scale (PSPRS) (r rm = -0.25, p < 0.0001).ConclusionThe MoCA appears to have limited sensitivity in capturing cognitive decline in PSP.
| S-EPMC11704677 | biostudies-literature
Project description:IntroductionAppropriate tools and references are essential for evaluating individuals' cognitive levels. This study validated the Taiwan version of the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog) and provided normative data for the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and ADAS-cog in community-dwelling older adults.MethodsMMSE, MoCA, and ADAS-cog were administered to 150 nondemented healthy adults aged 55-85 years during 2018-2020 as part of the Northeastern Taiwan Community Medicine Research Cohort. ADAS-cog was translated from the original English version to traditional Chinese with cultural and language considerations in Taiwan. Cronbach's alpha (α) tested the reliability of ADAS-cog, and Pearson correlations examined its external validity using MMSE and MoCA as comparisons. Normative data were generated and stratified by age and education, and the one-way analysis of variance compared scores between age and education groups. Another 20 hospital-acquired participants with cognitive impairment joined the 150 healthy participants. Comparisons in the Clinical Dementia Rating (CDR) tiers tested the discriminability of the tests for different cognitive levels. The area under the receiver operating characteristic curve (AUROC) analyzed the power of ADAS-cog in predicting CDR 0.5 from CDR 0.ResultsThe Taiwan version of ADAS-cog had fair reliability between items (α = 0.727) and good correlations to MMSE (r = -0.673, p < 0.001) and MoCA (r = -0.746, p < 0.001). The normative data of MMSE, MoCA, and ADAS-cog showed ladder changes with age (p = 0.006, 0.001, and 0.437) and education (p < 0.001, <0.001, and <0.001) in the 150 nondemented older adults. Next, in the 170 mixed participants from the communities and the hospital, MMSE, MoCA, and ADAS-cog scores were well differentiable between CDR 0, 0.5, and 1. In addition, ADAS-cog discriminated CDR 0.5 from 0 by an AUROC of 0.827 (p < 0.001).Discussion/conclusionThe three structured cognitive tests consistently reflect cognitive levels of healthy older adults. The Taiwan version of ADAS-cog is compatible with MMSE and MoCA to distinguish people with mildly impaired from normal cognition. In addition, this study derived MMSE, MoCA, and ADAS-cog norms tailored to demographic factors. The findings highlight the need for stratification of age and education rather than applying a fixed cutoff for defining normal and abnormal cognition.
| S-EPMC9677874 | biostudies-literature
Project description:Background and purposeFace-to-face cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face cognitive tests in patients with transient ischemic attack (TIA) or stroke.MethodsIn a population-based study, consecutive community-dwelling patients underwent the MoCA and neuropsychological battery >1 year after TIA or stroke, followed by T-MoCA (22 points) and TICSm (39 points) at least 1 month later. Mild cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the receiver-operating characteristic curve (AUC) determined for T-MoCA and TICSm.ResultsNinety-one nondemented subjects completed neuropsychological testing (mean±SD age, 72.9±11.6 years; 54 males; stroke 49%) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction, and verbal fluency were significantly worse (P<0.02) by telephone than during face-to-face testing. Reliability of diagnosis for MCI (AUC) were T-MoCA of 0.75 (95% confidence interval [CI], 0.63-0.87) and TICSm of 0.79 (95% CI, 0.68-0.90) vs face-to-face MoCA of 0.85 (95% CI, 0.76-0.94). Optimal cutoffs were 18 to 19 for T-MoCA and 24 to 25 for TICSm. Reliability of diagnosis for MCI (AUC) was greater when only multi-domain impairment was considered (T-MoCA=0.85; 95% CI, 0.75-0.96 and TICSm=0.83, 95% CI, 0.70-0.96) vs face-to-face MoCA=0.87; 95% CI, 0.76-0.97).ConclusionsBoth T-MoCA and TICSm are feasible and valid telephone tests of cognition after TIA and stroke but perform better in detecting multi-domain vs single-domain impairment. However, T-MoCA is limited in its ability to assess visuoexecutive and complex language tasks compared with face-to-face MoCA.
| S-EPMC5593099 | biostudies-literature
Project description:BackgroundThe use of a reliable remote cognitive screening test for older adults is crucial for the diagnosis of cognitive impairment. This study aimed to translate and validate the audiovisual Montreal Cognitive Assessment (MoCA)for older adults in Brazil.MethodsOne hundred and fourteen older adults were recruited from the community and demographic, functional, mood, and cognitive data were collected. Participants were classified into two groups: cognitively healthy or mild cognitive impairment (MCI). Statistical analyses were performed in order to assess the validity of the test and the cutoff score.ResultsThe psychometric properties of the audiovisual MoCA showed good convergent validity. The audiovisual MoCA was represented as a unifactorial adjusted model, the composite reliability value was acceptable and a cutoff point of ≥23 reached adequate sensitivity and specificity at 0.77 and 0.92, respectively.ConclusionsThe translated audiovisual MoCA is a valid and reliable cognitive screening test that can be administered remotely in older adults in Brazil. The test demonstrated a great ability to discriminate older adults with MCI from cognitively healthy adults. Future studies should focus on validating the audiovisual MoCA using other target population groups in order to expand the use of this remote screening test.
| S-EPMC10765722 | biostudies-literature
Project description:Background: There is a strong need for short and effective methods to screen for cognitive impairment. Recent studies have created short forms of the Montreal Cognitive Assessment (s-MoCA) in English-speaking populations. It is also important to develop a validated Chinese short version to detect cognitive impairment. Methods: Item response theory and computerized adaptive testing analytics were used to construct abbreviated MoCAs across a large neurological sample comprising 6,981 community-dwelling Chinese veterans. Results: Six MoCA items with high discrimination and appropriate difficulty were included in the s-MoCA. The Chinese short versions (sensitivity 0.89/0.90, specificity 0.72/0.77) are similar in performance to the full MoCA in identifying cognitive impairment (sensitivity 0.91, specificity 0.82). Conclusions: These short variants of the MoCA may serve as quick and effective instruments when the original MoCA cannot be feasibly administered in clinical services with a high patient burden and limited cognitive testing resources.
| S-EPMC8258379 | biostudies-literature