Use of the Montreal Cognitive Assessment and Alzheimer's Disease‐8 as cognitive screening measures in Parkinson's disease

Abstract

Objective to examine the sensitivity and specificity of the Montreal Cognitive Assessment (MoCA), a brief cognitive screening measure previously validated for use in Parkinson disease (PD), and Alzheimer’s Disease-8 (AD8), an eight-item informant report used to screen for dementia, but not yet validated for use in PD, to identify cognitive impairment in a sample of 111 patients with PD. Methods cognitive impairment was determined based on a battery of neuropsychological measures, excluding the MoCA and AD8. Classification rates of both the MoCA and AD8 in identifying cognitive impairment were examined using logistic regression and receiver operator characteristic (ROC) analysis. Optimal cutoff scores were determined to maximize sensitivity and specificity. Results the MoCA correctly classified 78.4% of participants (p<.001) and ROC analysis yielded an area under the curve (AUC) of .82. A MoCA cutoff score of <25 yielded optimal sensitivity (.77) and specificity (.79) for identifying PD patients with cognitive impairment. Similar analyses for the AD8 were statistically nonsignificant, although the classification rate was 70.5%, with an AUC of .50. Conclusions these results provide additional support for the MoCA, but not the AD8, in identifying cognitive impairment in patients with PD.

Development of cognitive screening test for the severely hearing impaired: Hearing‐impaired MoCA

“…The gold standard to identify cognitive changes that may be indicative of dementia remains formal neuropsychological assessment involving the standardized administration of a broad battery of measures by a trained professional . To identify individuals who may benefit from such in‐depth neuropsychological testing, panels of experts worldwide have issued formal recommendations for general practitioners to screen for dementia in high‐risk groups . Historically, the Mini‐Mental State Examination (MMSE) has been widely used for cognitive screening.…”

“…Generally, a score of 26 or greater out of 30 is considered normal, taking into account education level. However, multiple studies have demonstrated the MMSE's low sensitivity in the screening of cognitive impairment, especially in those with mild cognitive impairment MCI …”

Montreal Cognitive Assessment and Mini-Mental State Examination reliable change indices in healthy older adults

“…Depending on the specific situation, batteries of cognitive tests are used, which usually include a screening method, or a screening tool is used as a single method to assess cognitive status of a patient. In comparison to the MMSE, the Montreal Cognitive Assessment (MoCA) is considered to be a more suitable, sensitive, and specific screening tool for the evaluation of cognitive impairment in early dementia or MCI (Nasreddine et al, 2005;Hoops et al, 2009;Gil et al, 2015;Brown et al, 2016;Ozer et al, 2016). However, it has been criticized because of its insensitivity to mild dementia or mild cognitive impairment (MCI) (Nasreddine et al, 2005).…”

“…However, it has been criticized because of its insensitivity to mild dementia or mild cognitive impairment (MCI) (Nasreddine et al, 2005). In comparison to the MMSE, the Montreal Cognitive Assessment (MoCA) is considered to be a more suitable, sensitive, and specific screening tool for the evaluation of cognitive impairment in early dementia or MCI (Nasreddine et al, 2005;Hoops et al, 2009;Gil et al, 2015;Brown et al, 2016;Ozer et al, 2016).…”

Determination of MoCA Cutoff Score in Patients with Alcohol Use Disorders

“…However, this cutoff value was questioned by several authors and it has been suggested that the MoCA score varies according to age (Tan et al., ) and the etiology of the cognitive disorder (Brown et al., ; Copersino et al., ; Zuo et al., ). For example, a cutoff score ranging from 23 to 24 correctly classified patients suffering from brain injury (Chen et al., ), while a cutoff score > 25 correctly classified patients suffering from Parkinson's disease (Brown et al., ) and patients suffering from substance use disorders (Copersino et al., ). Moreover, it is recommended to correct the raw score for educational level and to add 1 point to the total score when the education level is equal to or lower than 12 years.…”