Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

Sobreira, Emmanuelle Silva Tavares; Pena-Pereira, Márcio Alexandre; Éckeli, Alan Luiz; Sobreira-Neto, Manoel Alves; Chagas, Marcos Hortes Nisihara; Foss, Maria Paula; Cholerton, Brenna; Zabetian, Cyrus P.; Mata, Ignacio; Tumas, Vítor

doi:10.1590/0004-282x20150156

Cited by 28 publications

(41 citation statements)

References 26 publications

(38 reference statements)

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“…This study showed that the TMSE cut‐off point to detect PDD is higher, reflecting lower performance, than it is for PD. However, we found that the MoCA cut‐off point to detect PDD was lower than in previous studies . This should be taken into consideration when interpreting these positive screening tests.…”

Section: Discussioncontrasting

confidence: 71%

Cognitive profiles and optimal cut‐offs for routine cognitive tests in elderly individuals with Parkinson's disease, Parkinson's disease dementia, Alzheimer's disease, and normal cognition

et al. 2019

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Aim: The cognitive impairment seen in Parkinson's disease (PD) results in patient disability and reduced quality of life. However, using cognitive screening scales specific to PD in routine clinical practice is difficult because of limited time, resources, and skills. We studied the ability of routine cognitive tests to differentiate between Parkinson's disease dementia (PDD) and PD and among the neuropsychological profiles of elderly individuals with PD, PDD, Alzheimer's disease (AD), and normal cognition. Methods: This cross-sectional study involved 124 subjects. Subjects were 35 cognitively normal elderly and 37 elderly individuals with PD, 22 with PDD, and 30 with AD. All subjects were diagnosed by a specialist using standard criteria. Clinically relevant data and scores from the Montreal Cognitive Assessment and the Thai Mental State Examination were collected. Cognitive test scores were compared among groups. Receiver operating characteristic curves were constructed for a range of cut-off points to explore the sensitivity and specificity of the screening tools to detect PDD. Results: There were 74 female subjects (59.7%), and the average age of all subjects was 75.6 years. The median score on the modified Hoehn and Yahr scale was 2.5 in subjects with PD and 4 in those with PDD (P < 0.001). The cut-offs for differentiating PDD from PD were 25 on the Thai Mental State Examination and 14 on the Montreal Cognitive Assessment. The sensitivity of the Thai Mental State Examination was 78.4%, and the specificity was 66.7% (area under the curve: 0.828). The sensitivity of the Montreal Cognitive Assessment was 81.1%, and the specificity was 75% (area under the curve: 0.876). There was a significant difference in the memory and language subdomains between AD and PDD (P < 0.05). Conclusions:The cut-offs used to differentiate PDD from PD were not the same as routine cut-offs in distinguishing AD from normal elderly. The cognitive profile deficit in PDD differed from that in AD. Interpretations of positive screenings test should take this finding into consideration.

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Section: Discussioncontrasting

confidence: 71%

Cognitive profiles and optimal cut‐offs for routine cognitive tests in elderly individuals with Parkinson's disease, Parkinson's disease dementia, Alzheimer's disease, and normal cognition

et al. 2019

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“…Defining a single, optimal MoCA cutoff score from the large number of validation studies is further limited by the fact that the majority of studies have been conducted in specific patient populations, such as those with cerebrovascular conditions (e.g., Cumming et al, 2013;Dong et al, 2010Dong et al, , 2012Freitas et al, 2012b;Godefroy et al, 2011;Pendlebury et al, 2012Pendlebury et al, , 2013Webb et al, 2014;Wong, Lam, et al, 2013a) cardiovascular conditions (Hawkins et al, 2014;McLennan et al, 2011), Parkinson's disease (e.g., Chen et al, 2013;Dalrymple-Alford et al, 2010;Gill et al, 2008;Hoops et al, 2009;Kasten et al, 2010;Krishnan et al, 2015;Ozdilek & Kenangil, 2014;Sobreira et al, 2015), HIV (Koski et al, 2011;Milanini et al, 2014;Janssen et al, 2015;Joska et al, 2016;Overton et al, 2013), Traumatic Brain Injury (Wong, Ngai, et al, 2013b), psychiatric conditions (Gierus et al, 2015;Musso et al, 2014), Huntington disease (Bezdicek et al, 2013), and Korsokoff syndrome (Oudman et al, 2014;Wester et al, 2013).…”

mentioning

confidence: 99%

A re‐examination of Montreal Cognitive Assessment (MoCA) cutoff scores

Carson

Leach²,

Murphy

2017

Int J Geriat Psychiatry

518

355

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“…The Mini-Mental State Examination may be insufficient to detect cognitive dysfunction in PD patients with OSA and could explain why we did not find differences between the cognition of OSA and non-OSA patients. It might have been better to have used Addenbrooke' s Cognitive Examination or Montreal Cognitive Assessment scales to evaluate cognition 34 . With regard to excessive sleepiness, Merino-Andreu et al documented the inadequate perception of the wake-sleep transition in PD patients, and this could be a possible explanation for the absence of a difference in this variable, when measured by a subjective scale, such as the Epworth Sleepiness Scale 35 .…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and Parkinson's disease: characteristics and associated factors

Sobreira-Neto

Pena-Pereira

Sobreira

et al. 2019

Arq. Neuro-Psiquiatr.

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Obstructive sleep apnea (OSA) occurs in up to 66% of Parkinson's disease (PD) patients, higher than in the general population. Although it is more prevalent, the relationship between OSA and PD remains controversial, with some studies confirming and others denying the relationship of OSA with some risk factors and symptoms in patients with PD. Objective: To determine the factors associated with OSA in PD patients com DP. Methods: A cross-sectional study was performed with 88 consecutive patients with PD from the outpatient clinic. Participants underwent clinical interviews with neurologists and a psychiatrist, assessment using standardized scales (Epworth Sleepiness Scale, Parkinson's Disease Questionnaire, Pittsburgh Sleep Quality Index and, for individuals with a diagnosis of restless legs syndrome/Willis-Ekbom disease, the International Restless Legs Syndrome Rating Scale), and video-polysomnography. Results: Individuals with PD and OSA were older and had less insomnia than those with PD without OSA. Regarding the polysomnographic variables, we observed a lower percentage of stage N3 sleep, a higher arousal index, and a higher oxygen desaturation index in those individuals with OSA, relative to those without OSA. In the multivariate analysis, only the percentage of stage N3 sleep and the oxygen desaturation index were significantly different. Besides this, most of the PD patients with OSA had a correlation with sleeping in the supine position (58% of OSA individuals). Conclusion: The PD patients showed a high prevalence of OSA, with the supine position exerting a significant influence on the OSA in these patients, and some factors that are associated with OSA in the general population did not seem to have a greater impact on PD patients.

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Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

Cited by 28 publications

References 26 publications

Cognitive profiles and optimal cut‐offs for routine cognitive tests in elderly individuals with Parkinson's disease, Parkinson's disease dementia, Alzheimer's disease, and normal cognition

Cognitive profiles and optimal cut‐offs for routine cognitive tests in elderly individuals with Parkinson's disease, Parkinson's disease dementia, Alzheimer's disease, and normal cognition

A re‐examination of Montreal Cognitive Assessment (MoCA) cutoff scores

Obstructive sleep apnea and Parkinson's disease: characteristics and associated factors

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