Montreal Cognitive Assessment: Influence of Sociodemographic and Health Variables

Abstract

The Montreal Cognitive Assessment (MoCA) is a brief cognitive instrument for screening milder forms of cognitive impairment. The present study aimed to analyze the influence of sociodemographic (age, gender, educational level, marital and employment status, geographic region, geographic localization, and residence area) and health variables (subjective memory complaints of the participant and evaluated by the informant, depressive symptoms, and family history of dementia) on the participants' performance on the MoCA. The investigation was carried out in a Portuguese community-based sample of 650 cognitively healthy adults, who were representative of the distribution observed in the Portuguese population. Educational level and age significantly contributed to the prediction of the MoCA scores, explaining 49% of the variance. Regarding health variables, only the subjective memory complaints of the participant showed a small contribution (9%) to the variance on the MoCA scores. This study contributes a useful approach to understanding MoCA performance, stressing the great impact of education and age on scores.

The Relevance of Sociodemographic and Health Variables on MMSE Normative Data

“…Considering the geographical variables, consistent with the results obtained in a previous study using the MoCA (Freitas et al, 2012), our results indicate that there were no statistically significant differences between subjects living in different geographic regions, the coast vs. inland areas, or in predominantly urban vs. rural areas.…”

“…There are no Portuguese studies on the influence of geographic variables on the MMSE performance, however in a previous study from our group with the Montreal Cognitive Assessment (MoCA; Nasreddine et al, 2005), no association was found between geographic variables and the performance of the cognitively healthy adults (Freitas et al, 2012). Other variables were occasionally analyzed in previous studies.…”

“…The influence of marital status is more contentious between studies, as some have reported greater performances among married individuals (Fratiglioni, Wang, Ericsson, Maytan, & Winblad, 2000;Nguyen et al, 2002;Ribeiro et al, 2010;Wu, Lan, Chen, Chiu, & Lan, 2011). Information regarding employment status is rather scarce (Freitas, Simões, Alves & Santana, 2012); individuals currently employed and individuals with occupations with high intellectual demands seem to achieve better scores on the MMSE (Anderson et al, 2007;Moraes et al, 2010). Finally, it is difficult to investigate the influence of geographical variables on cognitive tests and international inter-study comparison has revealed itself as meaningless due to the specificities of the populations and territories.…”

“…Mías and collaborators (2007) observed a lack of association between these variables. In a previous study, we explored the impact of these health variables on cognitive performance and observed that only the subjective memory complaints referred by the participant (not by the informants) showed a small contribution to the variance of the scores obtained from the MoCA (Freitas et al, 2012).…”

Educational bias in the assessment of severe dementia: Brazilian cutoffs for severe Mini-Mental State Examination

“…Thus, there is a need for cultural adaptations in many low and middle income countries in order to compensate for the educational and cultural biases of the original versions 16,18 . In accordance with this situation, several studies have demonstrated that cognitive performance in screening tests is directly influenced by sociodemographic variables such as age and education [19][20][21] . To the best of our knowledge, this is the first study to analyze the SMMSE in a Brazilian population with low schooling and, taking into account the considerable sample size, our results emphasized the need for culturally adapted tests to be used in this setting.…”