Optimal cut-off MoCA score for screening for mild cognitive impairment in elderly individuals in China: A systematic review and meta-analysis

Sun, Rui; Ge, Binqian; Wu, Songping; Li, Huiling; Liu, Lin

doi:10.1016/j.ajp.2023.103691

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…We are aware that a high cut-off poses a risk of false positive decisions regarding the exclusions of participants. Yet, we decided to keep the cut-off of 26 to ensure high sensitivity, in accordance with previous studies [31]. The recruitment rate (61%) was acceptable.…”

Section: Methodsmentioning

confidence: 83%

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults – preliminary results of a randomized controlled study

Szczepocka,

Mokros,

Kaźmierski

et al. 2024

BMC Psychiatry

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Background/Aims Older age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults. Methods Seventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65–85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups. Results The users performed, on average, 39.8 sessions (range 1–100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants’ sex, age, and years of education. The differences in CNS Vital Signs’ global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant. Conclusions VR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size. Trial registration Clinicaltrials.gov ID NCT05369897.

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Section: Methodsmentioning

confidence: 83%

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults – preliminary results of a randomized controlled study

Szczepocka,

Mokros,

Kaźmierski

et al. 2024

BMC Psychiatry

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“…The study outcome was PSCI at 3 months assessed by mini-mental state examination (MMSE) 16 and Montreal Cognitive Assessment (MoCA) 17 in Chinese. Both MMSE and MoCA have been validated as effective screening tools for cognitive impairment in the Chinese population.…”

Section: Methodsmentioning

confidence: 99%

“…18 In this study, PSCI was defined as MMSE score <27 16 or MoCA score <25. 17 PSCI severity was categorized as follows: severe cognitive impairment (MMSE scores, 0–22; MoCA scores, 0–19), mild cognitive impairment (MMSE scores, 23–26; MoCA scores, 20–24), and no cognitive impairment (MMSE scores, 27–30; MoCA scores, 25–30). 19,20 In the sensitivity analyses, we also defined PSCI using the following age- and education-adjusted thresholds of MMSE and MoCA: MMSE score <26.5 or MoCA score <19.5 for participants with age ≤75 years and education ≤6 years; MMSE score <22.5 or MoCA score <15.5 for participants with age >75 years and education ≤6 years; MMSE score <28.5 or MoCA score <24.5 for participants with age ≤75 years and education >6 years; and MMSE score <26.5 or MoCA score <24.5 for participants with age >75 years and education >6 years.…”

Section: Methodsmentioning

confidence: 99%

“…Both MMSE and MoCA have been validated as effective screening tools for cognitive impairment in the Chinese population. 16,17 The MMSE is an 11-item scale that tests 5 areas of cognitive function: orientation, registration, attention and calculation, recall, and language, with a maximum score of 30. 18 The MoCA evaluates visuospatial/executive functions, naming, memory, attention, language, abstraction, and orientation, and is also scored out of 30.…”

Section: Outcome Assessmentmentioning

confidence: 99%

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High-Serum Brain-Derived Neurotrophic Factor Levels Are Associated With Decreased Risk of Poststroke Cognitive Impairment

Chang,

You,

Yang

et al. 2024

Stroke

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Background: BDNF (brain-derived neurotrophic factor) is widely implicated in the pathophysiological process of stroke, but the effect of BDNF on poststroke cognitive impairment (PSCI) remains unclear. We aimed to investigate the association between baseline serum BDNF and the risk of PSCI at 3 months in a multicenter study based on a preplanned ancillary study of the CATIS trial (China Antihypertensive Trial in Acute Ischemic Stroke). Methods: We examined serum BDNF levels at baseline and used the Mini-Mental State Examination and Montreal Cognitive Assessment to evaluate cognitive function at 3-month follow-up after ischemic stroke. PSCI was defined as Mini-Mental State Examination score <27 or Montreal Cognitive Assessment score <25. Logistic regression analyses were performed to evaluate the association between serum BDNF and the risk of 3-month PSCI. Results: In this ancillary study, a total of 660 patients with ischemic stroke with hypertension were included, and 593 patients (mean age, 59.90±10.44 years; 410 males and 183 females) were finally included in this analysis. According to mini-mental state examination score, after adjustment for age, sex, education, baseline National Institutes of Health Stroke Scale score, APOE ɛ4 carriers, and other potential confounders, the odds ratio of PSCI for the highest tertile of BDNF was 0.60 ([95% CI, 0.39–0.94]; P =0.024) compared with the lowest tertile. Multiple-adjusted spline regression model showed a linear association of serum BDNF levels with PSCI at 3 months ( P value for linearity=0.010). Adding serum BDNF to conventional prognostic factors slightly improved the risk reclassification of PSCI (net reclassification improvement: 27.46%, P =0.001; integrated discrimination index: 1.02%, P =0.015). Similar significant findings were observed when PSCI was defined by the Montreal Cognitive Assessment score. Conclusions: Elevated serum BDNF levels were associated with a decreased risk of PSCI at 3 months, suggesting that serum BDNF might be a potential predictive biomarker for PSCI among patients with ischemic stroke with hypertension.

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“…CSVD patients showed total WMH Fazekas scores ranging from 1 to 6 . CSVD patients with MCI that exhibited some degree of cognitive decrease, as determined by family members and neuropsychological assessments (i.e., solely MoCA scores < 26 or MoCA scores = 26 and TMT-B (s) > 188), − were termed the CSVD-CI group ( N = 60) while those with normal cognitive function were termed the CSVD-CN group ( N = 57). The matched HCs had normal cognition and showed no imaging changes reflecting cerebrovascular disease.…”

Section: Methodsmentioning

confidence: 99%

Macrophage Migration Inhibitory Factor as a Potential Plasma Biomarker of Cognitive Impairment in Cerebral Small Vessel Disease

Shi,

Deng,

Mao

et al. 2024

ACS Omega

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As the pathogenesis of cerebral small vessel disease with cognitive impairment (CSVD-CI) remains unclear, identifying effective biomarkers can contribute to the clinical management of CSVD-CI. This study recruited 54 healthy controls (HCs), 60 CSVD-CI patients, and 57 CSVD cognitively normal (CSVD-CN) patients. All participants underwent neuropsychological assessments and multimodal magnetic resonance imaging. Macrophage migration inhibitory factors (MIFs) were assessed in plasma. The least absolute shrinkage and selection operator model was used to determine a composite marker. Compared with HCs or CSVD-CN patients, CSVD-CI patients had significantly increased plasma MIF levels. In CSVD-CI patients, plasma MIF levels were significantly correlated with multiple cognitive assessment scores, plasma levels of blood−brain barrier (BBB)related indices, white matter hyperintensity Fazekas scores, and the mean amplitude of low-frequency fluctuation in the right superior temporal gyrus. Higher plasma MIF levels were significantly associated with worse global cognition and information processing speed in CSVD-CI patients. The composite marker (including plasma MIF) distinguished CSVD-CI patients from CSVD-CN and HCs with >80% accuracy. Meta-analysis indicated that blood MIF levels were significantly increased in CSVD-CI patients. In conclusion, plasma MIF is a potential biomarker for early identification of CSVD-CI. Plasma MIF may play a role in cognitive decline in CSVD through BBB dysfunction and changes in white matter hyperintensity and brain activity.

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Optimal cut-off MoCA score for screening for mild cognitive impairment in elderly individuals in China: A systematic review and meta-analysis

Cited by 9 publications

References 34 publications

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults – preliminary results of a randomized controlled study

Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults – preliminary results of a randomized controlled study

High-Serum Brain-Derived Neurotrophic Factor Levels Are Associated With Decreased Risk of Poststroke Cognitive Impairment

Macrophage Migration Inhibitory Factor as a Potential Plasma Biomarker of Cognitive Impairment in Cerebral Small Vessel Disease

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