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

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.

A cross‐sectional study exploring cognitive impairment in kidney failure

“…The Montreal Cognitive Assessment (MoCA; Nasreddine et al, 2005), an extensively validated screening and clinical assessment tool in CKD (Amatneeks & Hamdan, 2019), was used to assess participants for cognitive impairment. The MoCA is a one page, 30‐point test that assesses several cognitive domains including executive function, visuospatial function, complex attention, language, memory recall and abstract thinking.…”

Can the Timed Up & Go Test and Montreal Cognitive Assessment predict outcomes in patients waitlisted for renal transplant?

“…Despite using a medical interpreter, the language component of MoCA may be representative of patients’ lack of comprehension due to language barriers rather than cognitive impairment. Translations of MoCA from English to other languages are feasible and effective; however, the cutoff values of MoCA scores for screening cognitive deficiencies vary based on language in other disease processes 42–49 . Therefore, despite using a medical translator, a limitation of this study is the effect of the language barrier on using MoCA.…”

“…20 This study demonstrated no association between for screening cognitive deficiencies vary based on language in other disease processes. [42][43][44][45][46][47][48][49] Therefore, despite using a medical translator, a limitation of this study is the effect of the language barrier on using MoCA. ESL is a compounding factor for failing MoCA, which unfortunately renders MoCA as an ineffective tool to appropriately differentiate patients with frailty and genuine cognitive decline versus patients with a language barrier.…”

Quality of life and cognitive assessment in healthy older Asian people with early and moderate chronic kidney disease: The NAHSIT 2013–2016 and validation study

“…These could limit the generalizability and comparability of similar studies. Some studies [ 80 , 81 ] indicated that the Montreal Cognitive Assessment (MoCA) showed better utility as a tool for assessing patients with CKD. Third, we did not assess severe cardiovascular diseases or other neurological disorders in our study.…”