Montreal Cognitive Assessment 5-Minute Protocol Is a Brief, Valid, Reliable, and Feasible Cognitive Screen for Telephone Administration

Abstract

Background and Purpose The NINDS-CSN vascular cognitive impairment (VCI) Harmonization working group proposed a brief cognitive protocol for screening of VCI. We investigated the validity, reliability and feasibility of the Montreal Cognitive Assessment 5-minute protocol (MoCA 5-min protocol) administered over the telephone. Methods Four items examining attention, verbal learning and memory, executive functions/language and orientation were extracted from the MoCA to form the MoCA 5-min protocol. One hundred and four patients with stroke or TIA, including 53 with normal cognition (CDR 0) and 51 with cognitive impairment (CDR 0.5 or 1), were administered the MoCA in clinic and a month later, the MoCA 5-min protocol over the telephone. Results Administration of the MoCA 5-min protocol took five minutes over the telephone. Total score of the MoCA 5-min protocol correlated negatively with age (r=-0.36, p<0.001) and positively with years of education (r=0.41, p<0.001) but not with gender (rho=0.03, p=0.773). Total scores of the MoCA and MoCA 5-min protocol were highly correlated (r=0.87, p<0.001). The MoCA 5-min protocol performed equally well as the MoCA in differentiating patients with cognitive impairment from those without (AUC for MoCA 5-min protocol=0.78; MoCA=0.74, p>0.05 for difference; Cohen's d for group difference 0.801.13). It differentiated cognitively impaired patients with executive domain impairment from those without (AUC=0.89, p<0.001; Cohen's d=1.7 for group difference). 30-day test-retest reliability was excellent (Intraclass correlation coefficient=0.89). Conclusions The MoCA 5-min protocol is a free, valid and reliable cognitive screen for stroke and TIA. It is brief and highly feasible for telephone administration.

Video-based educational intervention associated with improved stroke literacy, self-efficacy, and patient satisfaction

“…All patients underwent the 5-minute protocol Montreal Cognitive Assessment (5-min MoCA) at admission and discharge for evaluation of their cognitive status. [21] Discharge mRS was also assessed. We also obtained feedback from study participants regarding their impressions of the video and suggestions for improvement.…”

Vascular cognitive impairment and dementia

“…Some have questioned whether this increased sensitivity has come at the cost of specificity [119], especially in patients with limited educational attainment. The Five Minute protocol from the VCI Harmonization Conference has also been shown to be sensitive to the effects of CVD [120]. …”

Sustained quality‐of‐life improvements over 10 years after deep brain stimulation for dystonia

“…The objective measurement was provided by a telephone interview based on the Telephone Montreal Cognitive Assessment (the T‐MoCA). The T‐MoCA excludes the visuospatial/executive and naming section of the MoCA, as they cannot be performed over the phone, and is scored out of a total of 22 points rather than the usual 30, with an abnormal cutoff of 18 of 22 . As a subjective tool, we employed a self‐administered survey comparing current day and presurgical cognitive function, the 39‐item Measurement of Every Day Cognition (Ecog‐39) .…”