Rapid cognitive screening of patients with substance use disorders.

Abstract

To date, there has not been a time-efficient and resource-conscious way to identify cognitive impairment in patients with substance use disorders (SUD). The present study assesses the validity, accuracy, and clinical utility of a brief (10 min) screening instrument, the Montreal Cognitive Assessment (MoCA), in identifying cognitive impairment among SUD patients. The Neuropsychological Assessment Battery-Screening Module (NAB-SM), a 45-minute battery with known sensitivity to the mild-to-moderate deficits observed in SUD patients, was used as the reference criterion for determining agreement, rates of correct and incorrect decision classifications, and criterion-related validity for the MoCA. Classification accuracy of the MoCA, based on receiver-operating characteristic (ROC) analysis, was strong, with an area under the ROC curve = 0.86 [95% CI: 0.75-0.97]. The MoCA also showed acceptable sensitivity (83.3%) and specificity (72.9%) for the identification of cognitive impairment. Using a cut-off of 25 on the MoCA, the overall agreement was 75.0%; chance-corrected agreement (kappa) was 41.9%. These findings indicate that the MoCA provides a time-efficient and resource-conscious way to identify SUD patients with neuropsychological impairment, thus addressing a critical need in the addiction treatment research community.

Is the Mini-Mental State Examination (MMSE) useful for eligibility screening of research participants with substance use disorder?

“…Montreal of Cognitive Assessment [Copersino et al, 2009], University of California-San Diego Brief Assessment of Capacity to Consent [Jeste et al, 2007], or assessment by qualified judges [Pachet et al, 2010]), aiming to find precision in the classification of ineligible participants or to have ulterior control of effects of cognitive functioning on collected data.…”

Daño cerebral relacionado con el alcohol. Situación actual y llamada a la acción

“…MOCA or Addenbrookes') (Copersino et al, 2009; Rojo-Mota, Pedrero-Perez, Ruiz-Sanchez de Leon, Llanero-Luque & Puerta-Garcia, 2013), and there is a great amount of evidence on screening for cognitive impairment in acquired brain damage (stroke, traumatic brain injury, HIV). But there is a shortage of literature about cognitive screening in alcoholism.…”

The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community

“…The MoCA takes 15 minutes to administer, is a free resource (Nasreddine, 2014), and can be administered by staff without formal neuropsychological training. Initial studies have found evidence supporting the use of the MoCA in AOD treatment settings (Copersino et al, 2009;Copersino et al, 2012).…”