Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Costa, Ana Sofia; Fimm, Bruno; Friesen, P; Soundjock, Herve; Rottschy, Claudia; Gross, Theresa; Eitner, Frank; Reich, Arno; Schulz, Jörg B.; Nasreddine, Ziad; Reetz, Kathrin

doi:10.1159/000340006

Cited by 102 publications

(83 citation statements)

References 31 publications

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“…While the Polish [54] and German [55] studies retained the original 1 point adjustment, the Dutch study [56] implemented a 2 point adjustment for ≤ 12 years of education.…”

Section: Europe (Germany Holland Poland Portugal)mentioning

confidence: 99%

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

O’Driscoll

Shaikh

2017

JAD

136

104

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The MoCA is widely used to screen for mild cognitive impairment. While there are many available versions, the cross cultural validity of the assessment has not been explored sufficiently.We aimed to interrogate the validity of the MoCA in a cross-cultural context: in differentiating mild cognitive impairment (MCI) from normal controls (NC); and identifying cut-offs and adjustments for age and education where possible. This review sourced a wide range of studies including case-control studies. In addition, we report findings for differentiating dementias from NC and MCI from dementias, however, these were not considered to be an appropriate use of the MoCA.The subject of the review assumes heterogeneity and therefore meta-analysis/es was not conducted. Quality ratings, forest plots of validated studies (sensitivity and specificity) with covariates (suggested cut-offs, age, education and country) and summary received operating characteristic curve (sROC) are presented.The results showed a wide range in suggested cutoffs for MCI cross culturally, with variability in levels of sensitivity and specificity ranging from low to high. Poor methodological rigour appears to have affected reported accuracy and validity of the MoCA.The review highlights the necessity for cross cultural considerations when using the MoCA, and recognizing it as a screen and not a diagnostic tool. Appropriate cutoffs and point adjustments for education are suggested.2

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“…While the Polish [54] and German [55] studies retained the original 1 point adjustment, the Dutch study [56] implemented a 2 point adjustment for ≤ 12 years of education.…”

Section: Europe (Germany Holland Poland Portugal)mentioning

confidence: 99%

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

O’Driscoll

Shaikh

2017

JAD

136

104

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“…5 The original and one of two alternate forms were administered to MCI, Alzheimer's disease, and a control group of patients within …”

Section: -3mentioning

confidence: 99%

“…5 The original and one of two alternate forms were administered to MCI, Alzheimer's disease, and a control group of patients within a 60-minute interval. A strong correlation between the alternate forms and the original MoCA was observed, indicating that all three forms could be used with reliability and alternatively for cognitive assessment.…”

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confidence: 99%

Validation of Montreal Cognitive Assessment, MoCA, Alternate French Versions

Nasreddine¹,

Patel

2016

Can. J. Neurol. Sci.

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Objective background: The Montreal Cognitive Assessment (MoCA) is a questionnaire that has been developed to help physicians around the world diagnose a patient's cognitive ability. Available in multiple languages and for use in multiple countries worldwide, the goal of this study was to validate the alternate versions 2 and 3 of the French MoCA test to assist physicians in the detection of mild cognitive impairment (MCI), while decreasing the learning effect upon frequent testing. Methods: A validation study was conducted at the MoCA Clinic and Institute in Québec, Canada. The subject population consisted of 25 patients diagnosed with MCI meeting Petersen criteria and 25 healthy subjects serving as the normal control (NC) group. Three MoCA test versions were administered in the French language in random order within one session. Scores obtained in all three versions in MCI and NC groups were assessed for reliability and consistency from one version to the next. Results: On average, scores obtained in each subject group (MCI and NC) fell within their corresponding diagnostic ranges (score above 26 points for NC patients versus scores below 26 points for MCI patients). Difference in scores observed between the original French MoCA version and the two alternate versions in each subject cohort were minimal and not considered clinically significant. Conclusions: All three test versions of the French MoCA are considered equivalent in diagnostic reliability and consistency and contribute to decreasing the potential learning effect when patients are required to repeat the test frequently. Mild cognitive impairment (MCI) is a transition state between normal aging and dementia. MCI diagnosis is most often determined by the presence or absence of memory impairment, the ability to continue general cognitive and functional activities, and the absence of diagnosed dementia. 1-3The MoCA, Montreal Cognitive Assessment, is 10-minute, one-page, 30-point cognitive screening test 4 used around the world to help detect MCI.Although MoCA was designed as a diagnostic screening tool, clinicians have increasingly used it on longitudinal assessments. Repeated measures may lead to a practice effect and decrease the test validity. The development of reliable alternate versions would counteract these inconveniences.In 2012, Ana Costa et al developed two alternate forms for the German MoCA test with the goal of determining the reliability of the alternate forms for longitudinal assessments. 5 The original and one of two alternate forms were administered to MCI, Alzheimer's disease, and a control group of patients within METHODS ParticipantsTwenty-five subjects with amnestic MCI who met the Petersen criteria, 6 who underwent a recent (less than 6 months) confirmation by a neuropsychological assessment (with a minimum of 1.5 standard deviations below normal on the Rey Auditory Verbal Learning Test) were recruited at the MoCA Clinic and Institute in Québec, Canada, to form the MCI group. Subjects were aged 55 years or older (averag...

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“…Studies in older persons from community or memory clinic-based populations have yielded slightly lower reliabilities (0.75-0.92); however, these tended to involve longer test-retest intervals in the range of 4-8 weeks or longer [45,46,47,49,50,51]. The reliability of newly available alternate forms of the MoCA has been established for memory clinic samples comprised of MCI and Alzheimer's disease [52], but not for patients with cerebrovascular disease. Inter-rater reliability was 0.87 for the Hong Kong version of the MoCA in patients with small vessel disease and 0.95 for the Chinese version of the MoCA in patients with MCI or Alzheimer's disease [45].…”

Section: Internal Structurementioning

confidence: 99%

Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Koski¹

2013

Cerebrovasc Dis

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Cognitive impairment is common among patients with stroke or other cerebrovascular disease and influences long-term outcome, including occupational functioning. Recognition and monitoring of mild cognitive impairment is thus essential to good patient care. The Montreal Cognitive Assessment (MoCA) has been suggested as a brief screening test of vascular cognitive impairment. This paper presents a critical review of the research literature evaluating the validity and utility of this test with the aim of informing future clinical and research practice. A total of 30 papers employing the MoCA in the context of cerebrovascular disease were identified. Reporting of the methods and results of such studies tended to fall short of the established reporting guidelines. Under-specification of the exclusion criteria applied and their impact make it difficult to assess the potential impact of sampling bias and loss to follow-up. Nevertheless, content validity evidence suggests that the MoCA covers most of the domains that represent cognitive impairment in cerebrovascular disease, with mixed evidence for its preferential sensitivity to the type of cognitive impairment encountered in the context of vascular disease. Evidence clearly supports the need to establish norms and cut-offs for the MoCA that are culturally appropriate and that are matched to the range of cognitive impairment that is present in the population being assessed. Recent modifications of the MoCA have been developed for assessing patients with visual impairment or restricted mobility, which may reduce the impact of ‘untestability' on cognitive screening in the clinic or research context. The MoCA correlates well with other measures of cognitive and functional abilities in patients with cerebrovascular disease, and may also predict future response to rehabilitation and long-term occupational outcome. Further research is needed to provide evidence for the validity of the MoCA in longitudinal studies. However, it compares favourably to the Mini Mental State Examination as a screening test that is sensitive to the milder forms of cognitive impairment that often accompany cerebrovascular disease.

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Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Cited by 102 publications

References 31 publications

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

Validation of Montreal Cognitive Assessment, MoCA, Alternate French Versions

Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

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