Comparative sensitivity of the MoCA and Mattis Dementia Rating Scale‐2 in Parkinson's disease

Hendershott, Taylor R.; Zhu, Delphine; Llanes, Seoni; Zabetian, Cyrus P.; Quinn, Joseph F.; Edwards, Karen L.; Leverenz, James B.; Montine, Thomas J.; Cholerton, Brenna; Poston, Kathleen L.

doi:10.1002/mds.27575

Cited by 14 publications

(15 citation statements)

References 31 publications

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“…We had successfully established modifications of the MoCA for remote telehealth administration, and we thus took this opportunity to switch from the DRS-2 to the MoCA as the main cognitive summary score in patient evaluations. The MoCA summary score reportedly is a more sensitive marker of cognitive impairment than the DRS-2 (Hendershott et al, 2019).…”

Section: Test Modificationsmentioning

confidence: 91%

Emory university telehealth neuropsychology development and implementation in response to the COVID-19 pandemic

Hewitt

Loring

2020

The Clinical Neuropsychologist

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Objectives: Emory University has modified its clinical practices across specialties in response to the 2020 COVID-19 pandemic to provide service delivery while maintaining patient, staff, and faculty safety. This report shares current solutions and workarounds associated with telehealth neuropsychology (teleNP) while also recognizing teleNP opportunities. Results: We modified many measures from our traditional assessment protocols so they could be administered through Zoom. To maximize quality control, formal how-to coversheets and manuals were developed for both training and task administration (i.e. navigating Zoom assessment interfaces, practicing adapted test instructions, and troubleshooting). Conclusions: TeleNP has been successfully used to answer referral questions regarding deep brain stimulation (DBS) candidacy in Parkinson's disease patients and presence of mild neurocognitive impairment in patients with subjective memory decline. Our current protocols will continue to evolve with greater experience and are not considered to be a finished product. Nevertheless, development of robust teleNP protocols should expand availability of neuropsychology in both clinical and research applications while simultaneously decreasing assessment burden associated with traveling-sometimes long distances-for diagnostic neuropsychological evaluation.

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Section: Test Modificationsmentioning

confidence: 91%

Emory university telehealth neuropsychology development and implementation in response to the COVID-19 pandemic

Hewitt

Loring

2020

The Clinical Neuropsychologist

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“…The DRS‐2 was administered during the comprehensive neuropsychological assessment and the English version of the MoCA was administered during a neurology visit within 12 months of the neuropsychological assessment (time difference in years: M = −0.38; SD = 0.28). Variables for the MoCA and DRS‐2 are the total scores and the frequency of scores below PD‐specific suggested cutoffs (MoCA ≤ 26; 21–25 DRS‐2 ≤ 139) 24,26 …”

Section: Methodsmentioning

confidence: 99%

Multiculturalism: A Challenge for Cognitive Screeners in Parkinson's Disease

Statucka

Cherian

Fasano

et al. 2021

Movement Disord Clin Pract

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BackgroundBackground: The Montreal Cognitive Assessment (MoCA) and the Dementia Rating Scale-2 (DRS-2) are recommended screeners for Parkinson's disease mild cognitive impairment (PD-MCI). Cross-cultural studies examining their diagnostic precision have not addressed cultural bias in a multicultural setting. Objectives Objectives: To compare DRS-2 and MoCA performance between patients born in Canada, the USA, and the UK (Anglosphere group) and immigrant patients born elsewhere (International group). To identify sources of cultural bias by comparing group characteristics, and by assessing the relationships between performance and immigration and socio-development variables. To examine the diagnostic precision of both tools in detecting PD-MCI in each group. Methods Methods: We conducted a clinical chart review of advanced PD patients who completed cognitive screeners (MoCA: n = 288, 30% International group; DRS-2: n = 426, 31% International group). All completed a comprehensive neuropsychological assessment to apply Level II PD-MCI diagnostic criteria. Results Results: The International group performed worse than the Anglosphere group on the MoCA and DRS-2, and the only variable that accounted for some of the group difference was the Historical Index of Human Development, a societal variable, which fully mediated the group effect on the DRS-2. Diagnostic precision of the MoCA was at chance level in the International group, and was poorer than that of the DRS-II in this group and that of the MoCA in the Anglosphere group, although these were considered poor. Conclusions Conclusions: Our results support the recommendation to exert caution in using cognitive screeners to capture PD-MCI in all patients and particularly with first generation immigrants.Cognitive decline is a prevalent symptom of Parkinson's disease (PD). While a comprehensive neuropsychological assessment is the gold standard for PD dementia (PDD) 1 and mild cognitive impairment (PD-MCI) 2 diagnoses, resources are often limited and repeating assessments over time is not feasible. Instead, cognitive screeners are more amenable to routine care and tools such as the Mattis Dementia Rating Scale-2 (DRS-2) 3 and the Montreal Cognitive Assessment (MoCA) 4 are recommended for use in PD. 5 Both scales are translated into numerous languages and are validated for PD around the globe, albeit with variable pass/ fail scores. These cross-cultural initiatives, however, do not address the challenge of cognitive testing in a multicultural setting.Cultural bias on cognitive tasks within multicultural societies is seldom examined in PD research. In other clinical groups, bias was mainly demonstrated in testing of racial/ethnic groups in the USA, with the confounds of education, literacy, socioeconomic status and general health differences. 6,7 Such research may not generalize to multicultural societies such as Toronto, Canada where immigrants represent 50% of the population, 8 and are generally healthy 9,10 and highly educated. 8 Because normative data from immigrants' ...

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“…We recruited 121 participants from the Stanford Movement Disorders Clinic and the surrounding community as previously described. [18][19][20] PD was diagnosed using the UK Parkinson's Disease Society Brain Bank clinical diagnostic criteria. 21 Healthy controls (HCs) were neurologically normal on exam and within 1.5 standard deviations (SDs) of normative values on comprehensive cognitive testing.…”

Section: Participantsmentioning

confidence: 99%

White Matter Hyperintensities Related to Parkinson's Disease Executive Function

Linortner

McDaniel

Shahid

et al. 2020

Movement Disord Clin Pract

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Background People with Parkinson's disease (PD) can develop multidomain cognitive impairments; however, it is unclear whether different pathologies underlie domain‐specific cognitive dysfunction. Objectives We investigated the contribution of vascular copathology severity and location, as measured by MRI white matter hyperintensities (WMHs), to domain‐specific cognitive impairment in PD. Methods We studied 85 PD (66.6 ± 9.2 years) and 18 control (65.9 ± 6.6) participants. Using the Fazekas scale for rating the severity of WMH, we subdivided PD into 14 PD–WMH+ and 71 PD–WMH–. Participants underwent global, executive, visuospatial, episodic memory, and language testing. We performed nonparametric permutation testing to create WMH probability maps based on PD‐WMH group and cognitive test performance. Results The PD–WMH+ group showed worse global and executive cognitive performance than the PD–WMH– group. On individual tests, the PD–WMH+ group showed worse Montreal Cognitive Assessment (MoCA), Stroop, Symbol Digit Modalities Test (SDMT), and Digit Span scores. WMH probability maps showed that in the PD–WMH+ group, worse Stroop was associated with lesions centered around the corticospinal tract (CST), forceps major, inferior‐fronto‐occipital fasciculus, and superior longitudinal fasciculus; worse SDMT with lesions around the CST, forceps major, and posterior corona radiata; worse Digit Span with lesions around the posterior corona radiata; and worse MoCA with lesions around the CST. Conclusions We found that WMH severity was associated with PD executive dysfunction, including worse attention, working memory, and processing speed. Disruption of key white matter tracts in proximity to vascular lesions could contribute to these specific cognitive impairments. Early treatment of vascular disease might mitigate some executive dysfunction in a subset of patients with PD.

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Comparative sensitivity of the MoCA and Mattis Dementia Rating Scale‐2 in Parkinson's disease

Cited by 14 publications

References 31 publications

Emory university telehealth neuropsychology development and implementation in response to the COVID-19 pandemic

Emory university telehealth neuropsychology development and implementation in response to the COVID-19 pandemic

Multiculturalism: A Challenge for Cognitive Screeners in Parkinson's Disease

White Matter Hyperintensities Related to Parkinson's Disease Executive Function

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