Things to watch out for when using the Montreal cognitive assessment (MoCA)

Coen, Robert F.; Cahill, Richard A.; Lawlor, Brian A.

doi:10.1002/gps.2471

Cited by 33 publications

(27 citation statements)

References 4 publications

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“…SDNN2 is shown instead of SDNN as it is indicative of total power and yielded identical significance to SDNN in analysis. Regression analysis using a dichotomised MOCA score, according to the criteria for cognitive impairment (scores below 24) [7,17], yielded broadly similar results (not shown). Further sub--analysis stratifying by gender yielded similar results between men and women.…”

Section: Resultsmentioning

confidence: 65%

Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results

Frewen¹,

Finucane

Savva³

et al. 2013

Clin Auton Res

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ObjectiveTo examine the independent association between heart rate variability (HRV) and cognitive performance, in a nationally representative population study of older adults. MethodsCross--sectional analysis of wave 1 data from the Irish longitudinal study on ageing (TILDA) was performed. A subset of 4,763 participants who underwent ECG recording during resting and paced breathing periods were used for the analysis. HRV indices were divided into quintiles for comparison of values and cognitive performance was defined using the Montreal cognitive assessment (MOCA) score. Multivariate linear regression was used to model the association between cognition and different quintiles of each HRV index, after adjustment for covariates. ResultsThe mean age was 61.7 ± 8.3 years and 2,618 (55 %) were female. Lower quintiles of SDNN (P = 0.01--paced), LF (P = 0.001--paced), and LF:HF ratio (P = 0.049--paced) were significantly associated with lower MOCA scores (during both recording periods), independent of confounders. Sub--domains of MOCA responsible for the relationship were predominantly memory recall and language. InterpretationReduced HRV is significantly associated with lower cognitive performance at a population level in people aged 50 and older. This further strengthens the relationship between autonomic dysfunction and cognitive disorders.

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Section: Resultsmentioning

confidence: 65%

Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results

Frewen¹,

Finucane

Savva³

et al. 2013

Clin Auton Res

Self Cite

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“…Previously, the original 26 points cutoff score yielded lower specificity in a sample from a memory clinic (Smith et al, 2007). Three later studies found that a score of 23 showed higher accuracy to detect MCI (Luis et al, 2009;Coen et al, 2011;Tsai et al, 2011). Additionally, a normative study found that a cut-off score around 23 points would be more realistic to identify MCI Median 12 (IQI 10-15) Median 9 (IQI 7-12) Median 8 (IQI 6-10) < 0.001 Abstraction Median 2 (IQI 2-2) Median 2 (IQI 1-2) Median 1 (IQI 1-2) < 0.001 Recall Median 4 (IQI 2-5) Median 2 (IQI 0-3) Median 0 (IQI 0-0) < 0.001 Orientation Median 6 (IQI 6-6) Median 6 (IQI 6-6) Median 5 (IQI 4-6) < 0. in a community sample (Rossetti et al, 2011).…”

Section: Discussionmentioning

confidence: 98%

A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?

Cecato

Martinelli

Izbicki

et al. 2015

Int. Psychogeriatr.

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“…The MoCA in particular is subject to ongoing debate. It is argued that the universal cut-off score of less than 26 may over diagnose the existence of true cognitive impairment [46], and cut-offs of less than 23 have been suggested as having better clinical utility in stroke [46,47]. Its brevity is useful in the context of stroke where patient fatigue may be prevalent, however, it is a brief screening tool for mild cognitive impairment (MCI) and therefore does not capture all post-stroke deficits.…”

Section: Discussionmentioning

confidence: 99%

Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study

et al. 2015

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BackgroundCognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing recurrent stroke and the incidence of stroke-related cognitive impairment and dementia. The aim of this study was to profile cognitive impairment of stroke survivors at six months, and to identify factors associated with cognitive impairment post-stroke, focusing on indicators of adequate secondary prevention and psychological function.MethodsParticipants were assessed at six months following an ischaemic stroke as part of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke study (ASPIRE-S), which examined the secondary preventive and rehabilitative profile of patients in the community post-stroke. Cognitive impairment was measured using the Montreal Cognitive Assessment (MoCA).ResultsTwo-hundred and fifty-six stroke patients were assessed at six months. Over half of the sample (56.6%) were found to have cognitive impairment, with significant associations between cognitive impairment and female sex (odds ratio (OR) = 1.6, 95% CI 1.01-2.57) and history of cerebrovascular disease (OR = 2.22, 95% CI 1.38-3.59). Treatment with antihypertensive medications (OR = .65, 95% CI .44-.96) and prescription of anticoagulant therapy (OR = .41, 95% CI .26-.68) were associated with reduced likelihood of cognitive impairment, however increasing number of total prescribed medications was moderately associated with poorer cognitive impairment (OR = 1.12, 95% CI 1.04-1.19).ConclusionsFindings reveal levels of cognitive impairment at 6 months post-stroke that are concerning. Encouragingly, aspects of secondary prevention were identified that may be protective in reducing the incidence of cognitive impairment post-stroke. Neuropsychological rehabilitation post-stroke is also required as part of stroke rehabilitation models to meet the burden of post-stroke cognitive impairment.

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Things to watch out for when using the Montreal cognitive assessment (MoCA)

Cited by 33 publications

References 4 publications

Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results

Cognitive function is associated with impaired heart rate variability in ageing adults: the Irish longitudinal study on ageing wave one results

A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?

Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study

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