Investigation of the Montreal Cognitive Assessment (MoCA) as a cognitive screener in severe mental illness

Musso, Mandi W.; Cohen, Alex S.; Auster, Tracey L.; McGovern, Jessica E.

doi:10.1016/j.psychres.2014.07.078

Cited by 44 publications

(23 citation statements)

References 21 publications

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“…The findings of this study demonstrate the susceptibility of individuals with depressive symptoms to obtain impaired scores on the MoCA, not unlike other cognitive screens (prose recall, clock drawing, verbal fluency, and trail making) (see Musso et al for similar MoCA findings in severe mental illness impacting mood 32 ). Thus, these results provide an important caveat/potential explanatory factor for clinicians when using the MoCA to interpret a patient's global cognition.…”

Section: Discussionsupporting

confidence: 56%

Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

Blair

Coleman

Jesso

et al. 2016

Can. J. Neurol. Sci.

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Objective: The Montreal Cognitive Assessment (MoCA) is a general cognitive screening tool that has shown sensitivity in detecting mild levels of cognitive impairment in various clinical populations. Although mood dysfunction is common in referrals to memory clinics, the influence of mood on the MoCA has to date been largely unexplored. Method: In this study, we examined the impact of mood dysfunction on the MoCA using a memory clinic sample of individuals with depressive symptoms who did not meet criteria for a neurodegenerative disease. Results: Half of the group with depressive symptoms scored below the MoCA-suggested cutoff for cognitive impairment. As a group, they scored below healthy controls, but above individuals with Alzheimer's disease and frontotemporal dementia. A MoCA subtask analysis revealed a pattern of executive/attentional dysfunction in those with depressive symptoms. Conclusions: This observed negative impact of depressive symptomatology on the MoCA has interpretative implications for its utility as a cognitive screening tool in a memory clinic setting. Bien qu'une dysfonction de l'humeur soit fréquente chez les patients référés à des cliniques de la mémoire, l'influence de l'humeur sur le MoCA n'a encore jamais été explorée. Méthode: Nous avons examiné l'impact d'un trouble de l'humeur sur le MoCA chez un échantillon de patients d'une clinique de la mémoire présentant des symptômes de dépression qui ne rencontraient pas les critères diagnostiques d'une maladie neurodégénérative. Résultats: La moitié du groupe présentant des symptômes de dépression avait un score sous le niveau suggéré par le MoCA pour le diagnostic d'une atteinte cognitive. En tant que groupe, leur score était inférieur à celui des témoins en bonne santé, mais supérieur à celui des patients atteints de la maladie d'Alzheimer ou de démence fronto-temporale. L'analyse des sous-tâches a montré un profil de dysfonction exécutive/de l'attention chez ceux qui présentaient des symptômes dépressifs. Conclusions: L'impact négatif de la symptomatologie dépressive sur le MoCa que nous avons observé a des implications sur l'interprétation de ce test concernant son utilité comme outil de dépistage cognitif dans le contexte d'une clinique de la mémoire.

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Section: Discussionsupporting

confidence: 56%

Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

Blair

Coleman

Jesso

et al. 2016

Can. J. Neurol. Sci.

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“…The MoCA has proven to be a sensitive tool for screening patients with other forms of dementia, such as vascular dementia, 45 dementia associated with Parkinson's disease, 46 and finally frontotemporal dementia. 47 With respect to psychiatric disorders, the MoCA has been used successfully to evaluate cognitive impairment in patients with depression, BD, and schizophrenia 48,49 as well as in depressed patients undergoing ECT. 50…”

Section: Cognitive Screening: the Mocamentioning

confidence: 99%

Using network analysis to explore cognitive domains in patients with unipolar versus bipolar depression: a prospective naturalistic study

Galimberti¹,

Bosi

Caricasole

et al. 2019

CNS Spectr.

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Objective: Despite growing evidence in the field of cognitive function in mood disorders, the neurocognitive profiles of patients with unipolar and bipolar depression still need further characterization. In this study, we applied network analysis, hypothesizing this approach could highlight differences between Major Depressive Disorder (MDD) and Bipolar Disorder (BD) from a cognitive perspective. Methods: The cognitive performance of 109 patients (72 unipolar and 37 bipolar depressed outpatients) was assessed through the Montreal Cognitive Assessment (MoCA) and a series of clinical variables was collected. Differences in cognitive performance between MDD and BD patients were tested using non parametric tests. Moreover, a network graph representing MoCA domains as nodes and Spearman's rho correlation coefficients between the domains as edges was constructed for each group. Results: The presence of mild cognitive impairment was observed both in MDD and BD patients during depression. No statistical significant difference was found between the two groups in terms of overall cognitive performance and across single domains. Nonetheless, network analytic metrics demonstrated different roles of memory and executive dysfunction in MDD vs BD patients: in particular, MDD network was more densely interconnected than BD network and memory was the node with the highest betweenness and closeness centrality in MDD, while executive function was more central in BD. Conclusions:From a network analytic perspective, memory impairment displays a central role in the cognitive impairment of patients with unipolar depression, whereas executive dysfunction appears to be more central in bipolar depression. Further research is warranted to confirm our results.

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“…Although the MMSE was initially developed to grade cognitive impairment and to follow the course of cognitive impairment over time, and the MoCA was initially developed for mild cognitive impairment, the MMSE has been widely used since 1975 and the MoCA since 2005 for other indications. 16 , 17 The MoCA has become increasingly popular as a cognitive screening instrument in various clinical settings, 19 because a considerable body of research shows it to be superior to the MMSE in detecting milder forms of cognitive impairment in various patient populations, including those with Parkinson’s disease 20 , 21 Huntington’s disease 22 frontotemporal dementia 23 and many others. 24 , 25 , 26 , 27 The superiority of the MoCA to the MMSE for detecting mild cognitive impairment in Parkinson’s disease and frontotemporal dementia was confirmed by a battery of neuropsychological tests.…”

Section: Introductionmentioning

confidence: 99%

A comparison between the Mini-Mental State Examination and the Montreal Cognitive Assessment Test in schizophrenia

Rademeyer

Joubert

2016

S. Afr. J. Psych.

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BackgroundCognitive impairment is a core feature of schizophrenia that also has strong prognostic significance. In most clinical settings comprehensive neuropsychological testing to detect cognitive impairment in schizophrenia patients is not readily available, but because cognitive deficits in schizophrenia are clinically important it would be useful to detect or at least screen for them in a clinical setting. Unfortunately there are no validated, brief screening instruments for the detection of cognitive impairment in schizophrenia. Nevertheless, the Montreal Cognitive Assessment Test (MoCA) and the Mini-Mental State Examination (MMSE) show promise in this regard. The objective of this study was to compare the results of the MMSE and MoCA in a group of outpatient schizophrenia sufferers to contribute to research into the instruments’ potential usefulness as screening tools for cognitive impairment in schizophrenia.MethodThe Afrikaans versions of the MMSE and MoCA were administered to Afrikaans-speaking adult outpatients. Participants had at least seven years of formal education and had been in partial or full remission for at least 3 months. The MMSE and MoCA scores for each participant were matched and compared using the non-parametric Wilcoxon matched pairs test.ResultsThe sample consisted of 30 Afrikaans-speaking outpatients with schizophrenia. The mean MMSE score was 27.17 ± 2.64, and the mean MoCA score was 22.53 ± 3.91. There was a statistically significant difference between participants’ performance on the MMSE and MoCA tests (p = 0.000008).ConclusionCompared to the MMSE, the MoCA may be a more useful instrument to detect cognitive impairment in patients with schizophrenia. Further studies are required.

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Investigation of the Montreal Cognitive Assessment (MoCA) as a cognitive screener in severe mental illness

Cited by 44 publications

References 21 publications

Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

Using network analysis to explore cognitive domains in patients with unipolar versus bipolar depression: a prospective naturalistic study

A comparison between the Mini-Mental State Examination and the Montreal Cognitive Assessment Test in schizophrenia

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