The Montreal Cognitive Assessment and Neurobehavioral Cognitive Status Examination are useful for screening mild cognitive impairment in Japanese patients with Parkinson's disease

Abstract

Aim Diagnosis of mild cognitive impairment (MCI) in Parkinson's disease (PD; PD‐MCI) can be difficult. We examined whether the Japanese version of the Montreal Cognitive Assessment (MoCA‐J) and the Neurobehavioral Cognitive Status Examination (COGNISTAT‐J) were suitable to screen PD‐MCI. Methods A total of 50 patients with PD and PD with dementia, took the Mini‐Mental State Examination (MMSE), MoCA‐J and COGNISTAT‐J (except 3 patients) tests. Impairment in each cognitive domain on the tests was then compared between groups. Results Of 25 patients with a high MMSE score of 27 or above, 13 had a MoCA‐J score of below 25, and showed significantly lower scores than 12 patients with MoCA‐J scores of 25 or above in the visuospatial, executive and memory domains of MoCA. Of the 25 patients with a high MMSE score, seven had four or more impaired subtests of the 10 subtests of COGNISTAT‐J. The seven patients showed significantly lower scores in the subtests of construction, calculation and similarity compared with the 18 patients with less than four impaired subtests. In patients with a high MMSE score and less than four impaired subtests on the COGNISTAT‐J, construction and memory were more impaired. Executive, visuospatial and memory abilities are characteristically impaired in PD‐MCI, therefore both MoCA‐J and COGNISTAT‐J detected characteristics of PD‐MCI in patients with a high MMSE score. Conclusion Both MoCA and COGNISTAT are sensitive tools for screening for PD‐MCI.

Comparing the Montreal Cognitive Assessment with Mini‐Mental State Examination in Japanese Parkinson's disease patients

“…The MoCA score was significantly lower than the MMSE score (P < 0.0001). The MoCA score showed a greater range (5-30) compared with the MMSE score (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

“…Participants with a MMSE score of 26-30 showed a greater range of MoCA score (15-30) compared with that of the MMSE score. The 304 patients were grouped into tertiles according to MoCA score; that is, into low MoCA score (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), middle MoCA score (19-23) and high MoCA score (24-30) groups ( Table 2). The MMSE score of the high MoCA score group was 28.8 AE 1.3, and the mean + SD exceeded the maximum MMSE score (30), which represented a ceiling effect.…”

Correlation between motor and cognitive functions in the progressive course of Parkinson's disease

“…22 The MoCA used in the present study is sensitive to cognitive impairments in the early phase of PD. 9 We believe that specific motor and cognitive impairments that share a common pathophysiology emerge together from an early phase of PD. Therefore, both motor and cognitive functions should not be separately evaluated in a clinical setting.…”

“…The Montreal cognitive assessment (MoCA) is more sensitive than the MMSE for screening mild cognitive impairment . Furthermore, MoCA has proved sensitive to detect early cognitive impairment in PD patients, because it includes tests assessing frequently impaired cognitive domains in PD, such as visuospatial and executive skills, and memory . As far as we know, the MoCA has not been used to study a possible correlation between motor and cognitive functions in PD.…”

Demonstration of Early Cognitive Impairment in Parkinson’s Disease with Visual P300 Responses

“…It is well known that the loss of dopaminergic neurons in the basal ganglia in the early stages of PD results in disruption of the fronto-striatal circuits (37,38,39). Moreover, prominent hypoactivity has been reported in cholinergic pathways in PD (40).…”