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Wei Q, Du B, Liu Y, Cao S, Yin S, Zhang Y, Ye R, Bai T, Wu X, Tian Y, Hu P, Wang K. The Montreal cognitive assessment: normative data from a large, population-based sample of Chinese healthy adults and validation for detecting vascular cognitive impairment. Front Neurosci 2024; 18:1455129. [PMID: 39145298 PMCID: PMC11322342 DOI: 10.3389/fnins.2024.1455129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Background The Montreal Cognitive Assessment (MoCA) is a valuable tool for detecting cognitive impairment, widely used in many countries. However, there is still a lack of large sample normative data and whose cut-off values for detecting cognitive impairment is considerable controversy. Methods The assessment conducted in this study utilizes the MoCA scale, specifically employing the Mandarin-8.1 version. This study recruited a total of 3,097 healthy adults aged over 20 years. We performed multiple linear regression analysis, incorporating age, gender, and education level as predictor variables, to examine their associations with the MoCA total score and subdomain scores. Subsequently, we established normative values stratified by age and education level. Finally, we included 242 patients with vascular cognitive impairment (VCI) and 137 controls with normal cognition, and determined the optimal cut-off value of VCI through ROC curves. Results The participants in this study exhibit a balanced gender distribution, with an average age of 54.46 years (SD = 14.38) and an average education period of 9.49 years (SD = 4.61). The study population demonstrates an average MoCA score of 23.25 points (SD = 4.82). The multiple linear regression analysis indicates that MoCA total score is influenced by age and education level, collectively accounting for 46.8% of the total variance. Higher age and lower education level are correlated with lower MoCA total scores. A score of 22 is the optimal cut-off value for diagnosing vascular cognitive impairment (VCI). Conclusion This study offered normative MoCA values specific to the Chinese adults. Furthermore, this study indicated that a score of 26 may not represent the most optimal cut-off value for VCI. And for detecting VCI, a score of 22 may be a better cut-off value.
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Affiliation(s)
- Qiang Wei
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Baogen Du
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | | | - Shanshan Cao
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Shanshan Yin
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Ying Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Rong Ye
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Xingqi Wu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
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Suchy-Dicey AM, Vo TT, Oziel K, Buchwald DS, Rhoads K, French BF. Psychometric Reliability, Validity, and Generalizability of MoCA in American Indian Adults: The Strong Heart Study. Assessment 2024:10731911241261436. [PMID: 39046194 DOI: 10.1177/10731911241261436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Standardized neuropsychological instruments are used to evaluate cognitive impairment, but few have been psychometrically evaluated in American Indians. We collected Montreal Cognitive Assessment (MoCA) in 403 American Indians 70 to 95 years, as well as age, sex, education, bilingual status, depression symptoms, and other neuropsychological instruments. We evaluated inferences of psychometric validity, including scoring inference using confirmatory factor analysis and structural equation modeling, generalizability inference using reliability coefficient, and extrapolation inference by examining performance across different contexts and substrata. The unidimensional (total score) model had good fit criteria. Internal consistency reliability was high. MoCA scores were positively associated with crystallized cognition (ρ = 0.48, p < .001) and inversely with depression symptoms (ρ = -0.27, p < .001). Significant differences were found by education (d = 0.79, p < .05) depression (d = 0.484, p < .05), and adjudicated cognitive status (p = .0001) strata; however, MoCA was not sensitive or specific in discriminating cognitive impairment from normal cognition (area under the curve <0.5). MoCA scores had psychometric validity in older American Indians, but education and depression are important contextual features for score interpretability. Future research should evaluate cultural or community-specific adaptations, to improve test discriminability in this underserved population.
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Affiliation(s)
- Astrid M Suchy-Dicey
- Huntington Medical Research Institutes, Pasadena, CA, USA
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Thao T Vo
- Washington State University College of Education, Pullman, USA
| | - Kyra Oziel
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Dedra S Buchwald
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Kristoffer Rhoads
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Brian F French
- Washington State University College of Education, Pullman, USA
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Iype T, Raghunath SP, Paddick SM, Sudha LA, Krishnapilla V, Nair S, Robinson L. Montreal Cognitive Assessment (MoCA): Normative Data for the State of Kerala, South India. Neurol India 2024; 72:772-778. [PMID: 39216032 DOI: 10.4103/neurol-india.ni_294_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/06/2020] [Indexed: 09/04/2024]
Abstract
BACKGROUND Montreal cognitive assessment (MoCA) is a tool that is widely accepted across the world to measure mild cognitive impairment (MCI). The original cut-off score of MoCA falsely screens a large population of Indians as having MCI. OBJECTIVE The aim of this study was to develop the normative data for MoCA for the older population of Kerala, South India. MATERIAL AND METHODS We conducted the study among 959 cognitively normal older individuals of Kalliyoor village of Thiruvananthapuram district, Kerala. The validated Malayalam version of MoCA [MoCA-M] was administered by trained volunteers. The mean, median, and 10th percentile of the scores [domain-specific and total] were calculated in various age and educational groups. RESULTS The mean (SD) MoCA score was 19.4 (7.3). The 10th percentile for the total MoCA score was 9. The 10th percentile for all domains was zero, except for orientation. As age advanced, MoCA scores significantly reduced. The mean total MoCA scores dropped from 20.1 (7) [for ages between 65 and 75 years] to 7.4 (1.6) [for ages above 85 years]. We also obtained a significant improvement in scores among subjects with higher educational standards. CONCLUSION The study throws light into the performance of MoCA among the Indian population. This study defines the norms for the Indian population and suggests redefining the threshold for positively screening for MCI using MoCA-M.
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Affiliation(s)
- Thomas Iype
- Department of Neurology, Government Medical College, Thiruvananthapuram, Kerala, Executive Member of Health Action by People
| | - Sreelakshmi P Raghunath
- Department of Community Medicine, SUT Academy of Medical Sciences, Vattapara, Thiruvananthapuram, Kerala, India, Member of Health Action by People
| | - Stella M Paddick
- Academic Clinical Lecturer in Old Age Psychiatry [National Institute for Health Research, NIHR Clinical Lecturer in Old Age Psychiatry, Northumbria Tyne and Wear NHS Trust, Campus for Ageing and Vitality, United Kingdom
| | - Lijimol A Sudha
- Pallium India Trust, Paruthikuzhy, Manacadu, Thiruvananthapuram, Kerala
| | | | - Sanjeev Nair
- Department of Respiratory Medicine, Government Medical College, Thiruvananthapuram, Kerala, India, Executive Member of Health Action by People
| | - Louise Robinson
- Professor and Dame, Professor and Senior Investigator of Primary Care and Ageing [National Institute for Health Research], Population Health Sciences Institute, Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, United Kingdom
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Serrano PDL, Rodrigues TDPV, Pinto LD, Pereira IC, Farias IB, Cavalheiro RBR, Mendes PM, Peixoto KO, Barile JP, Seneor DD, Correa Silva EG, Oliveira ASB, Pinto WBVDR, Sgobbi P. Assessing Chitinases and Neurofilament Light Chain as Biomarkers for Adult-Onset Leukodystrophies. Curr Issues Mol Biol 2024; 46:4309-4323. [PMID: 38785530 PMCID: PMC11120026 DOI: 10.3390/cimb46050262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/19/2024] [Accepted: 04/28/2024] [Indexed: 05/25/2024] Open
Abstract
Leukodystrophies represent a large and complex group of inherited disorders affecting the white matter of the central nervous system. Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare leukodystrophy which still needs the proper identification of diagnostic, prognostic, and monitoring biomarkers. The aim of this study was to determine the diagnostic and prognostic value of chitinases and neurofilament light chain as biomarkers for ALSP. A cross-sectional study was performed to analyze cerebrospinal fluid levels of chitinases (chitotriosidase and chitinase 3-like 2) and neurofilament light chain in five different groups: (i) normal health individuals; (ii) patients with definitive diagnosis of ALSP and genetic confirmation; (iii) asymptomatic patients with CSF1R variants; (iv) patients with other adult-onset leukodystrophies; and (v) patients with amyotrophic lateral sclerosis (external control group). Chitinase levels showed a statistical correlation with clinical assessment parameters in ALSP patients. Chitinase levels were also distinct between ALSP and the other leukodystrophies. Significant differences were noted in the levels of chitinases and neurofilament light chain comparing symptomatic (ALSP) and asymptomatic individuals with CSF1R variants. This study is the first to establish chitinases as a potential biomarker for ALSP and confirms neurofilament light chain as a good biomarker for primary microgliopathies.
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Affiliation(s)
- Paulo de Lima Serrano
- PSEG Centro de Pesquisa Clínica, São Paulo 04038-002, SP, Brazil; (P.d.L.S.); (T.d.P.V.R.); (L.D.P.); (I.C.P.); (E.G.C.S.)
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | | | - Leslyê Donato Pinto
- PSEG Centro de Pesquisa Clínica, São Paulo 04038-002, SP, Brazil; (P.d.L.S.); (T.d.P.V.R.); (L.D.P.); (I.C.P.); (E.G.C.S.)
| | - Indiara Correia Pereira
- PSEG Centro de Pesquisa Clínica, São Paulo 04038-002, SP, Brazil; (P.d.L.S.); (T.d.P.V.R.); (L.D.P.); (I.C.P.); (E.G.C.S.)
| | - Igor Braga Farias
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Renan Brandão Rambaldi Cavalheiro
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Patrícia Marques Mendes
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Kaliny Oliveira Peixoto
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - João Paulo Barile
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Daniel Delgado Seneor
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | | | - Acary Souza Bulle Oliveira
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Wladimir Bocca Vieira de Rezende Pinto
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
| | - Paulo Sgobbi
- PSEG Centro de Pesquisa Clínica, São Paulo 04038-002, SP, Brazil; (P.d.L.S.); (T.d.P.V.R.); (L.D.P.); (I.C.P.); (E.G.C.S.)
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, Brazil; (I.B.F.); (R.B.R.C.); (P.M.M.); (K.O.P.); (J.P.B.); (D.D.S.); (A.S.B.O.); (W.B.V.d.R.P.)
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Umlauf A, Vaida F, Gupta S, Cherner M, Gershon RC, Heaton RK. Automated procedure for demographic adjustments on cognitive test scores. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 38052056 PMCID: PMC11150334 DOI: 10.1080/23279095.2023.2288231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Performances of normal people on cognitive tests are known to vary by demographic characteristics, such as age, education, and sex. Thus, cognitive test scores should be corrected for demographic influences when they are used to detect below-expected results due to disease or injury involving the central nervous system (CNS). Normative corrections, if estimated from a large, diverse, and well-characterized cohort of controls, help to remove expected differences in cognitive performance associated with normal demographic characteristics and associated socio-economic disadvantages. In this paper, we (1) describe in detail the process of generating regression-based normative standards, and its advantages and limitations, (2) provide recommendations for applying these normative standards to data from individuals and populations at risk for CNS dysfunction, and (3) introduce an R package, test2norm, that contains functions for producing and applying normative formulas to generate demographically corrected scores for measuring deviations from expected, normal cognitive performances.
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Affiliation(s)
- Anya Umlauf
- University of California San Diego, La Jolla, CA, USA
| | - Florin Vaida
- University of California San Diego, La Jolla, CA, USA
| | | | | | - Richard C Gershon
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Koshimoto BHB, Brandão PRDP, Borges V, Ferraz HB, Schumacher-Schuh AF, Rieder CRDM, Olchik MR, Mata IF, Tumas V, Santos-Lobato BL. Floor and ceiling effects on the Montreal Cognitive Assessment in patients with Parkinson's disease in Brazil. Dement Neuropsychol 2023; 17:e20230022. [PMID: 38053643 PMCID: PMC10695441 DOI: 10.1590/1980-5764-dn-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/10/2023] [Accepted: 07/30/2023] [Indexed: 12/07/2023] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease associated with cognitive impairment. The Montreal Cognitive Assessment (MoCA) has been used as a recommended global cognition scale for patients with PD, but there are some concerns about its application, partially due to the floor and ceiling effects. Objective To explore the floor and ceiling effects on the MoCA in patients with PD in Brazil. Methods Cross-sectional study with data from patients with PD from five Brazilian Movement Disorders Clinics, excluding individuals with a possible diagnosis of dementia. We analyzed the total score of the MoCA, as well as its seven cognitive domains. The floor and ceiling effects were evaluated for the total MoCA score and domains. Multivariate analyses were performed to detect factors associated with floor and ceiling effects. Results We evaluated data from 366 patients with PD and approximately 19% of individuals had less than five years of education. For the total MoCA score, there was no floor or ceiling effect. There was a floor effect in the abstraction and delayed memory recall domains in 20% of our sample. The ceiling effect was demonstrated in all domains (80.8% more common in naming and 89% orientation), except delayed recall. Education was the main factor associated with the floor and ceiling effects, independent of region, sex, age at evaluation, and disease duration. Conclusion The floor and ceiling effects are present in specific domains of the MoCA in Brazil, with a strong impact on education. Further adaptations of the MoCA structure for underrepresented populations may reduce these negative effects.
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Affiliation(s)
| | - Pedro Renato de Paula Brandão
- Universidade de Brasília, Laboratório de Neurociências e Comportamento, Brasília DF, Brazil
- Hospital Sírio-Libanês, Instituto de Ensino e Pesquisa, Brasília DF, Brazil
| | - Vanderci Borges
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil
| | - Henrique Ballalai Ferraz
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil
| | - Artur Francisco Schumacher-Schuh
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Porto Alegre RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil
| | - Carlos Roberto de Mello Rieder
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil
| | - Maira Rozenfeld Olchik
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil
- Universidade Federal do Rio Grande do Sul, Departamento de Cirurgia e Ortopedia, Porto Alegre RS, Brazil
| | - Ignacio Fernandez Mata
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Vitor Tumas
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências Comportamentais, Ribeirão Preto SP, Brazil
| | - Bruno Lopes Santos-Lobato
- Universidade Federal do Pará, Instituto de Ciências Médicas, Belém PA, Brazil
- Hospital Ophir Loyola, Serviço de Neurologia, Belém PA, Brazil
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Daniele de Araújo Silva J, Cândido Mendes Maranhão D, Machado Ferreira Tenório de Oliveira L, Luiz Torres Pirauá A. Comparison between the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on mental health and quality of life of older adults: Secondary analysis from a randomized clinical trial. Geriatr Gerontol Int 2023; 23:864-870. [PMID: 37743056 DOI: 10.1111/ggi.14673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
AIM The objective of this study was to compare the effects of virtual supervision and minimal supervision in a 12-week home-based physical exercise program on the mental health and quality of life of community-dwelling older adults. METHODS This study presents a secondary analysis of a randomized clinical trial conducted during the COVID-19 pandemic. The sample comprised 38 elderly men and women (81.6% women, mean age 68 ± 6.4 years; mean weight 69.8 ± 12.1 km) without physical and/or cognitive impairments. The volunteers were divided into two groups: one group received virtual supervision (monitored via videoconference), while the other group received minimal supervision (monitored through weekly text messages). Both groups followed the same home-based physical exercise program, consisting of three sessions per week, differing only in the supervision strategy. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21) in conjunction with the POMS questionnaire, which evaluates mood, and quality of life was assessed using the WHOQOL-OLD questionnaire. RESULTS Our findings demonstrated statistically significant superiority of virtual supervision compared with minimal supervision in relation to depression (-2.92, 95% confidence interval = -5.22 to -0.63). Conversely, minimal supervision exhibited superiority over virtual supervision regarding quality of life (-6.70, 95% confidence interval = -11.66 to -1.73). CONCLUSIONS Virtual supervision yielded better outcomes for the depression indicator, while minimal supervision favored the quality of life of older adults at the conclusion of the 12-week home-based physical exercise program. Geriatr Gerontol Int 2023; 23: 864-870.
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Silveira-Rodrigues JG, Campos BT, de Lima AT, Ogando PHM, Gomes CB, Gomes PF, Aleixo IMS, Soares DD. Acute bouts of aerobic and resistance exercise similarly alter inhibitory control and response time while inversely modifying plasma BDNF concentrations in middle-aged and older adults with type 2 diabetes. Exp Brain Res 2023; 241:1173-1183. [PMID: 36912948 DOI: 10.1007/s00221-023-06588-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/28/2023] [Indexed: 03/14/2023]
Abstract
Impairments in several domains of cognitive functions are observed in people with Type 2 Diabetes Mellitus (T2DM), often accompanied by low Brain-derived neurotrophic factor (BDNF) concentrations. Although aerobic and resistance exercise enhances cognitive functions and raises BDNF concentrations in several populations, it remained uncertain in T2DM subjects. This study compared the effects of a single bout of aerobic (AER, 40 min of treadmill walk at 90-95% of the maximum walk speed) or resistance (RES, 3 × 10 repetitions in eight exercises at 70% of 10-RM) exercise on specific cognitive domain performance and plasma BDNF concentrations of physically active T2DM subjects. Eleven T2DM subjects (9 women/2 men; 63 ± 7 years) performed two counterbalanced trials on non-consecutive days. Stroop Color and Word (SCW) task [assessing the attention (congruent condition) and inhibitory control (incongruent condition)], Visual response time (assessing the response time), and blood collection (for plasma BDNF concentrations) were performed pre and post-exercise sessions. With distinct magnitude, both AER and RES improved the incongruent-SCW (d = - 0.26 vs. - 0.43 in AER and RES, respectively; p < 0.05), RT(best) (d = - 0.31 vs. - 0.52, p < 0.05), and RT(1-5) (d = - 0.64 vs. - 0.21, p < 0.05). The congruent-SCW and RT(6-10) were not statistically different. Plasma BDNF concentrations were elevated 11% in AER (d = 0.30) but decreased by 15% in RES (d = - 0.43). A single session of aerobic or resistance exercise similarly improved the inhibitory control and response time of physically active T2DM subjects. Nevertheless, aerobic and resistance exercise sessions induced an opposite clinical effect in plasma BDNF concentrations.
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Affiliation(s)
- João G Silveira-Rodrigues
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
- Movement Laboratory, Medicine School, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Bruno T Campos
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - André T de Lima
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Pedro H M Ogando
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
- Movement Laboratory, Medicine School, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Camila B Gomes
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Patrícia F Gomes
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Ivana M S Aleixo
- Movement Laboratory, Medicine School, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Danusa D Soares
- Exercise Physiology Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil.
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9
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de Carvalho Rodrigues J, Fumagalli de Salles J, Ruschel Bandeira D. Evidence of validity based on the relation to other variables and inter-rater reliability of the Cognitive Screening (TRIACOG) for adults with cerebrovascular diseases. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:259-268. [PMID: 34078184 DOI: 10.1080/23279095.2021.1931219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study presents evidence of validity and reliability of the results obtained with the Cognitive Screening (TRIACOG) to evaluate post-stroke adults. The TRIACOG assesses orientation memory, language, arithmetic, praxis, information processing speed, and executive functions. A total of 126 post-stroke adults (M = 63.50; SD = 13.28 years old) and 126 neurologically healthy adults (M = 61.97; SD = 11.48 years old) participated in the study. Performance on the TRIACOG was positively correlated with scores on the Montreal Cognitive Assessment-Basic (MoCA-B), schooling, and reading and writing habits, and negatively correlated with the NIHSS and Rankin scales. Post-stroke adults scored lower and took longer to complete the instrument than neurologically healthy adults. Inter-rater agreement was achieved in scoring the TRIACOG. The TRIACOG presents evidence of validity based on its relationships to other variables (criterion and convergent) and on response processes, in addition to presenting reliability evidence established by inter-rater agreement. We expect that the TRIACOG will be employed by health workers in hospital settings, health units, and medical offices.
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Affiliation(s)
- Jaqueline de Carvalho Rodrigues
- Department of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS), Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Brazil
| | - Jerusa Fumagalli de Salles
- Department of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS), Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Brazil
| | - Denise Ruschel Bandeira
- Department of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS), Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Brazil
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10
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McDowell B, Marr C, Holmes C, Edwards CJ, Cardwell C, McHenry M, Meenagh G, McGuinness B. Prevalence of cognitive impairment in patients with rheumatoid arthritis: a cross sectional study. BMC Psychiatry 2022; 22:777. [PMID: 36494656 PMCID: PMC9733399 DOI: 10.1186/s12888-022-04417-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the role of chronic inflammation in rheumatoid arthritis (RA) on cognition. METHODS AND ANALYSIS Six hundred sixty-one men and women aged ≥55 years who fulfilled the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for RA were recruited from three healthcare trusts in the United Kingdom (UK) between May 2018 and March 2020. Study participants took part in interviews which captured sociodemographic information, followed by an assessment of cognition. RA specific clinical characteristics were obtained from hospital medical records. Participants were cognitively assessed using the Montreal Cognitive Assessment (MoCA) and were classified as cognitively impaired if they scored ≤27/30 points. Linear regression analyses were conducted to identify which demographic and clinical variables were potential predictors of cognitive impairment. RESULTS The average age of participants was 67.6 years and 67% (444/661) were women. 72% (458/634; 95% CI 0.69 to 0.76) of participants were classified as cognitively impaired (MoCA≤27). Greater cognitive impairment was associated with older age (p = .006), being male (p = .041) and higher disease activity score (DAS28) (with moderate (DAS28 > 3.1) (p = 0.008) and high (DAS28 > 5.1) (p = 0.008)) compared to those in remission (DAS28 ≤ 2.6). There was no association between MoCA score and education, disease duration, RF status, anti-cyclic citrullinated peptide (anti-CCP) status, RA medication type or use of glucocorticoids or non-steroidal anti-inflammatory drugs (p > 0.05). CONCLUSION This study suggests that cognitive impairment is highly prevalent in older adults with RA. This impairment appears to be associated with higher RA disease activity and supports the concept that chronic systemic inflammation might accelerate cognitive decline. This underlines the importance of controlling the inflammatory response.
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Affiliation(s)
- Bethany McDowell
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Calum Marr
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Clive Holmes
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, England ,grid.467048.90000 0004 0465 4159Southern Health NHS Foundation Trust, Southampton, England
| | - Christopher J. Edwards
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, England ,NIHR Southampton Clinical Research Facility, Southampton, England ,grid.430506.40000 0004 0465 4079University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Christopher Cardwell
- grid.4777.30000 0004 0374 7521Queen’s University Belfast, Belfast, Northern Ireland
| | - Michelle McHenry
- grid.412915.a0000 0000 9565 2378Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Gary Meenagh
- grid.413824.80000 0000 9566 1119Northern Health and Social Care Trust, Antrim, Northern Ireland
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Lo CKF, Yung EA, Tsang KT. Investigation of Play Intervention for Dementia (PID) Activities in Addressing Cognitive Domains Reflected in Hong Kong Montreal Cognitive Assessment (HK-MoCA). Gerontol Geriatr Med 2022; 8:23337214221130161. [PMID: 36275408 PMCID: PMC9580081 DOI: 10.1177/23337214221130161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background/Objectives: Yee Hong Play Intervention for Dementia (PID) is a community program strengthening East Asians >65 years with dementia in their daily functional activities. We analyzed how PID activities align with Hong Kong Montreal Cognitive Assessment. Methods: Utilizing observation sheets procured from documentation notes from the twice-weekly PID sessions, cognitive domains were identified. Mean time duration and activity frequencies were compared between high and low competency client groups. Results: Independent of competency group, activities predominantly targeted attention/concentration (23.8% HC, 16.4% LC), and hand-eye coordination (19.1% HC, 28.7% LC). Less focused domains were delayed recall (3.1-4.7%) and naming (1.3-1.5%). Conclusions: Yee Hong PID tested innovative cognitive domains not currently covered in HK-MoCA screening assessment, emphasizing attention/concentration-oriented activities and none assessing orientation and language domains. Additionally, presence of new domains such as hand-eye coordination and fine motor dexterity suggested that strict adherence with standardized screening tools (e.g., MoCA) may not be ideal. Likely, facilitators have developed innovative measures to assess individual competency to strengthen resilience in our geriatric population.
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Affiliation(s)
- Calvin Ka-Fung Lo
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada,Calvin Ka-Fung Lo, Department of Pathology and Laboratory Medicine, University of British Columbia, 317 – 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Eric Andrew Yung
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - Ka Tat Tsang
- Factor-Inwentash Faculty of Social Work, University of Toronto, ON, Canada
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12
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:73-87. [DOI: 10.1590/1980-5764-dn-2022-s105pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/13/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
RESUMO A demência da doença de Parkinson (DDP) e a demência com corpos de Lewy (DCL) representam a segunda causa mais comum de demência neurodegenerativa em pessoas com mais de 65 anos, ocasionando progressivo declínio cognitivo e comprometimento da qualidade de vida. O presente estudo tem como objetivo prover um consenso de especialistas sobre a DDP e DCL, baseado em revisão sistemática da literatura brasileira e revisão não-sistemática de literatura internacional. Ademais, tal estudo visa promover informação e conceder recomendações sobre abordagem diagnóstica, com foco nos níveis de atenção primária e secundária em saúde. Com base nos dados disponíveis, recomendamos que os profissionais realizem pelo menos um breve instrumento cognitivo global, como o Mini-Exame do Estado Mental, contudo de preferência optem pela Avaliação Cognitiva de Montreal e o Exame Cognitivo de Addenbrooke-Revisado. Observa-se uma carência de instrumentos validados para a avaliação precisa das habilidades funcionais em pacientes brasileiros com DDP e DCL. Além disso, mais estudos focando em biomarcadores com coortes brasileiras também são necessários.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Subjective cognitive decline, mild cognitive impairment, and dementia - syndromic approach: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s101en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Declínio cognitivo subjetivo, comprometimento cognitivo leve e demência - diagnóstico sindrômico: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:1-24. [DOI: 10.1590/1980-5764-dn-2022-s101pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/03/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
RESUMO Este consenso realizado pela Academia Brasileira de Neurologia (ABN) abordará de maneira prática como avaliar pacientes com queixas cognitivas e como realizar o diagnóstico clínico e etiológico das três síndromes clínicas associadas aos estágios de declínio cognitivo: declínio cognitivo subjetivo (DCS), comprometimento cognitivo leve (CCL) e demência. O diagnóstico de DCS é discutido pela primeira vez em consenso da ABN e as atualizações para o diagnóstico de CCL e demência são abordadas, bem como a recomendação para o uso de testes cognitivos apropriados, investigação etiológica pertinente e cuidados aos pacientes com declínio cognitivo nos diferentes níveis de atenção do Sistema Único de Saúde. Foi realizada pesquisa dos principais instrumentos de avaliação utilizados em nosso meio e na América Latina.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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15
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Parmera JB, Tumas V, Ferraz HB, Spitz M, Barbosa MT, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Souza LCD, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Castilhos RM, Frota NAF. Diagnosis and management of Parkinson’s disease dementia and dementia with Lewy bodies: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s105en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) represent the second most common type of degenerative dementia in patients aged 65 years and older, leading to progressive cognitive dysfunction and impaired quality of life. This study aims to provide a consensus based on a systematic Brazilian literature review and a comprehensive international review concerning PDD and DLB. Moreover, we sought to report on and give recommendations about the best diagnostic approaches focusing on primary and secondary care. Based on the available data, we recommend clinicians to apply at least one brief global cognitive instrument to assess PDD, such as the Mini-Mental State Examination and preferably the Montreal Cognitive Assessment and the Addenbrooke’s Cognitive Examination-Revised. Validated instruments to accurately assess functional abilities in Brazilian PD patients are still incipient. Further studies should focus on biomarkers with Brazilian cohorts.
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Affiliation(s)
| | | | | | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Brasil; Faculdade Ciências Médicas de Minas Gerais, Brasil
| | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Kessels RPC, de Vent NR, Bruijnen CJWH, Jansen MG, de Jonghe JFM, Dijkstra BAG, Oosterman JM. Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18-91. J Clin Med 2022; 11:4059. [PMID: 35887823 PMCID: PMC9318507 DOI: 10.3390/jcm11144059] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023] Open
Abstract
(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18-91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.
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Affiliation(s)
- Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Klimmendaal Rehabilitation Specialists, 6813 GG Arnhem, The Netherlands
- Tactus Addiction Care, 7400 AD Deventer, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Nathalie R. de Vent
- Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands;
| | - Carolien J. W. H. Bruijnen
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
| | - Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
| | | | - Boukje A. G. Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
- Novadic-Kentron, Addiction Care Center, 5261 LX Vught, The Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
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Al-Yawer F, Bruce H, Li KZH, Pichora-Fuller MK, Phillips NA. Sex-Related Differences in the Associations Between Montreal Cognitive Assessment Scores and Pure-Tone Measures of Hearing. Am J Audiol 2022; 31:220-227. [PMID: 35226818 DOI: 10.1044/2021_aja-21-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Hearing loss (HL) is associated with cognitive performance in older adults, including performance on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening test. Yet, despite well-established sex-related differences in both hearing and cognition, very few studies have tested whether there are sex-related differences in auditory-cognitive associations. METHOD In the current cross-sectional retrospective analysis, we examined sex-related differences in hearing and cognition in 193 healthy older adults (M = 69 years, 60% women). Hearing was measured using audiometry (pure-tone average [PTA] of thresholds at 500, 1000, 2000, and 4000 Hz in the worse ear). Cognition was assessed using the MoCA. Additionally, we calculated MoCA scores with hearing-dependent subtests excluded from scoring (MoCA-Modified). RESULTS Men and women did not differ in age, education, or history of depression. Women had better hearing than men. Women with normal hearing were more likely to pass the MoCA compared with their counterparts with HL. In contrast, the likelihood of passing the MoCA did not depend on hearing status in men. Linear regression analysis showed an interaction between sex and PTA in the worse ear. PTAs were significantly correlated with both MoCA and MoCA-Modified scores in women, whereas this was not observed in the men. CONCLUSIONS This study is one of the first to demonstrate significant sex-related differences in auditory-cognitive associations even when hearing-related cognitive test items are omitted. Potential mechanisms underlying these female-specific effects are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19233297.
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Affiliation(s)
- Faisal Al-Yawer
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
| | - Halina Bruce
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - M. Kathleen Pichora-Fuller
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Department of Psychology, University of Toronto, Mississauga, Ontario, Canada
- Department of Gerontology and Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
- Rotman Research Institute, Toronto, Ontario, Canada
| | - Natalie A. Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
- Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research/Jewish General Hospital/McGill University, Montréal, Québec, Canada
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Wajman JR, Cecchini MA. A simple counting of verbal fluency errors discriminates between normal cognition, mild cognitive impairment and Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 30:370-387. [PMID: 35174776 DOI: 10.1080/13825585.2022.2035668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
For this observational cross-sectional study, different modalities of verbal fluency tasks (VFTs) were compared between 143 participants: 35 cognitively healthy controls (CHCs), 71 mild cognitive impairment (MCI) and 37 mild Alzheimer's disease (AD) patients. Binomial logistic regression models were defined to identify VFT variables associated with MCI and AD, with respect to CHC. The results showed that the best errors/repetitions variable associated with MCI and AD was the phonemic task, and with every error the odds of being in the MCI group increased 9.9 times and 12.2 times in AD group, accompanied by high accuracy values (MCI: AUC = 0.824, sensitivity = 0.676, specificity = 0.943; AD: AUC = 0.883, sensitivity = 0.784, specificity = 0.943). The results suggest that, in addition to solely register raw scores, a simple counting of errors and repetitions during VFT can offer valuable clues in detecting MCI and AD, especially in the phonemic task.
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Affiliation(s)
- José R Wajman
- Department of Neurology and Neurosurgery, Hospital São Paulo, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mário A Cecchini
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, Edinburgh, UK
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19
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Engedal K, Gjra L, Benth JŠ, Wagle J, Rønqvist TK, Selbæk G. The Montreal Cognitive Assessment: Normative Data from a Large, Population-Based Sample of Cognitive Healthy Older Adults in Norway—The HUNT Study. J Alzheimers Dis 2022; 86:589-599. [DOI: 10.3233/jad-215442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Several studies have found that normative scores on the Montreal Cognitive Assessment Scale (MoCA) vary depending on the person’s education and age. The evidence for different normative scores between sexes is poor. Objective: The main aim of the study was to determine normative scores on the MoCA for Norwegian older adults stratified by educational level, age, and sex. In addition, we aimed to explore sex differences in greater detail. Methods: From two population-based studies in Norway, we included 4,780 people age 70 years and older. People with a diagnosis of dementia or mild cognitive impairment, a history of stroke, and depression were excluded. Trained health personnel tested the participants with the MoCA. Results: The mean MoCA score varied between 22 and 27 and was highest among women 70–74 years with education >13 years and lowest among men age 85 and older with education ≤10 years. Education, age, and sex were significant predictors of MoCA scores. Conclusion: In the present study of cognitively healthy Norwegian adults 70 years and older, we found that the normative score on the MoCA varied between 22 and 27 depending on a person’s education, age, and sex. We suggest that normative scores should be determined taking these three variables into consideration.
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Affiliation(s)
- Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Linda Gjra
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Jørgen Wagle
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Thale Kinne Rønqvist
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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20
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Cardoso J, Apagueno B, Lysne P, Hoyos L, Porges E, Riley JL, Fillingim RB, Woods AJ, Cohen R, Cruz-Almeida Y. Pain and the Montreal Cognitive Assessment (MoCA) in Aging. PAIN MEDICINE 2021; 22:1776-1783. [PMID: 33718961 DOI: 10.1093/pm/pnab003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The present study aimed to determine whether specific cognitive domains part of the Montreal Cognitive Assessment (MoCA) are significantly lower in community-dwelling older adults with chronic pain compared with older adults without pain and whether these domains would be associated with self-reported pain, disability, and somatosensory function. DESIGN Secondary data analysis, cross-sectional. SETTING University of Florida. SUBJECTS Individuals over 60 years old enrolled in the Neuromodulatory Examination of Pain and mobility Across the Lifespan (NEPAL) study were included if they completed the MoCA and other study measures (n = 62). Most participants reported pain on most days during the past three months (63%). METHODS Subjects underwent a health assessment (HAS) and a quantitative sensory testing (QST) session. Health/medical history, cognitive function and self-reported pain measures were administered during the HAS. Mechanical and thermal detection, and thermal pain thresholds were assessed during the QST session. RESULTS Older adults with chronic pain had lower MoCA scores compared with controls on domains of executive function, attention, memory, and language (P < 0.05). The attention and language domains survived adjustments for age, sex, education, depression, and pain duration (P < 0.05). Attention was significantly associated with all pain characteristics including pain intensity and disability, while executive function was associated with mechanical detection (P < 0.05). CONCLUSION Our results support previous findings that individuals with chronic pain tend to show poorer cognitive functioning compared with pain-free controls in domains of attention and executive function. Our findings also extend these findings to community-dwelling older adults, who are already most vulnerable to age-related cognitive declines.
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Affiliation(s)
- Josue Cardoso
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida
| | - Brandon Apagueno
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Paige Lysne
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida
| | - Lorraine Hoyos
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Eric Porges
- Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, Florida.,Department of Clinical & Health Psychology, College of Health Professions, University of Florida, Gainesville, Florida.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Joseph L Riley
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida
| | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida.,Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, Florida
| | - Adam J Woods
- Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, Florida.,Department of Clinical & Health Psychology, College of Health Professions, University of Florida, Gainesville, Florida.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Ronald Cohen
- Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, Florida.,Department of Clinical & Health Psychology, College of Health Professions, University of Florida, Gainesville, Florida.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida.,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida.,Center for Cognitive Aging & Memory, McKnight Brain Foundation, University of Florida, Gainesville, Florida.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida, USA
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21
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Tsiakiri A, Vadikolias K, Tripsianis G, Vlotinou P, Serdari A, Terzoudi A, Heliopoulos I. Influence of Social and Demographic Factors on the Montreal Cognitive Assessment (MoCA) Test in Rural Population of North-Eastern Greece. Geriatrics (Basel) 2021; 6:geriatrics6020043. [PMID: 33920668 PMCID: PMC8167640 DOI: 10.3390/geriatrics6020043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022] Open
Abstract
The current study aims to investigate the influence of socio-demographic factors on the Montreal Cognitive Assessment (MoCA) test results in a Greek-speaking population consisting of a sample of healthy older adults, individuals with mild cognitive impairment (MCI), and dementia patients in rural areas. In addition, the current research focuses on determining optimal cut-off scores for the clinical diagnoses of MCI and dementia. The data originated from 283 participants in an ongoing registry of the Neurology Department of Alexandroupolis University Hospital, recruited in different rural districts of north-eastern Greece, across a broad range of educational and occupational categories. Total and sub-domain scores for the MoCA varied significantly, according to sex, age, and education, among the three study groups. The optimal cut-off points of 25/26 for the MoCA total score was determined to classify healthy subjects from individuals with MCI, 24 to discriminate healthy participants from demented, and 21/22 to discriminate subjects with MCI from dementia. Overall, the clinical use of the MoCA test can be supported by demographically adjusted standard scores in a Greek-speaking rural population. These findings serve to improve the diagnostic accuracy and utility of the MoCA test.
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Affiliation(s)
- Anna Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Univeristy Hospital of Alexandroupolis, 68100 Dragana, Greece; (K.V.); (P.V.); (A.T.); (I.H.)
- Correspondence: ; Tel.: +30-6941582772
| | - Konstantinos Vadikolias
- Department of Neurology, Medical School, Democritus University of Thrace, Univeristy Hospital of Alexandroupolis, 68100 Dragana, Greece; (K.V.); (P.V.); (A.T.); (I.H.)
| | - Grigorios Tripsianis
- Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Pinelopi Vlotinou
- Department of Neurology, Medical School, Democritus University of Thrace, Univeristy Hospital of Alexandroupolis, 68100 Dragana, Greece; (K.V.); (P.V.); (A.T.); (I.H.)
| | - Aspasia Serdari
- Department of Child & Adolescent Psychiatry, Medical School, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100 Dragana, Greece;
| | - Aikaterini Terzoudi
- Department of Neurology, Medical School, Democritus University of Thrace, Univeristy Hospital of Alexandroupolis, 68100 Dragana, Greece; (K.V.); (P.V.); (A.T.); (I.H.)
| | - Ioannis Heliopoulos
- Department of Neurology, Medical School, Democritus University of Thrace, Univeristy Hospital of Alexandroupolis, 68100 Dragana, Greece; (K.V.); (P.V.); (A.T.); (I.H.)
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22
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Fernandes DE, Mastroianni Kirsztajn G, de Almeida K. Effect of hearing aids on attention, memory, and auditory evoked potentials: A pragmatic, single-blinded, and randomised pilot clinical trial. Int J Clin Pract 2021; 75:e13953. [PMID: 33345388 DOI: 10.1111/ijcp.13953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/16/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare the effects of hearing aids and their technology levels (premium and basic) on attention, memory, brain response, and self-perceived benefit amongst individuals who were naïve to sound amplification. MATERIAL AND METHODS A pragmatic, single-blinded, and randomised pilot clinical trial in three-parallel arms according to hearing aids technology: (a) premium; (b) basic; and (c) no amplification hearing devices. Participants were ≥60 years old with mild-to-moderate sensorineural symmetric hearing loss and naïve to sound amplification. We tested attention and memory skills, as well as brain response and self-perceived benefit before and after 12 weeks of using the hearing devices. The primary outcome was any improvement in the tests we performed. RESULTS The participants who missed the follow-up (n = 2) were excluded from our final analysis. We ended up with 22 patients (A = 8, B = 6, and C = 8) who were 80.4 (±6.1) years old, predominantly female (63.63%), and poorly educated (3.8 ± 1.6 years). After the intervention, we observed differences in attention and memory scores (reverse counting, P < .01, 95% CI 2.2; 11.63; digit sequence repetition, P = .03, 95% CI -1.9; -0.05; delayed recall, P = .03, 95% CI -1.2; -0.05; recognition, P < .01, 95% CI -2.6; -0.45; and visual memory, P < .01, 95% CI -0.9; -0.15), but only reverse counting (A vs C, P < .01,95% CI 5.9; 20.55) and recognition (B vs C, P < .01, 95% CI -6.1; -0.88) were observed in pairwise comparisons. The difference in N1 wave latency (/g/ sound, P = .01,95% CI 2.1; 18.59) could not be confirmed in pairwise comparison. The self-perceived benefit questionnaire revealed no difference between groups A and B; the groups A and C differed in benefit (P < .01, 95% CI -2.2; -0.76), satisfaction (P = .02,95% CI -2.0;-0.21), residual participation restrictions (P = .01, 95% CI -2.9; -0.38), and quality of life (P = .03, 95% CI -1.4; -0.08); the groups B and C differed in benefit (P < .001, 95% CI -2.3; -0.96), and satisfaction (P = .01,95% CI -2.1; -0.29). CONCLUSION In this study, premium and basic hearing aids impacted attention, memory, brain response, and self-perceived benefit similarly amongst individuals who were naïve to sound amplification after 12 weeks of using the hearing devices.
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Affiliation(s)
| | | | - Katia de Almeida
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
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23
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Custodio N, Duque L, Montesinos R, Alva-Diaz C, Mellado M, Slachevsky A. Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America. Front Aging Neurosci 2020; 12:270. [PMID: 33101004 PMCID: PMC7500065 DOI: 10.3389/fnagi.2020.00270] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the validity of brief cognitive screening (BCS) tools designed to diagnose mild cognitive impairment (MCI) or dementia in Spanish-speaking individuals over the age of 50 years from Latin America (LA). Methods: A systematic search of titles and abstracts in Medline, Biomed Central, Embase, Scopus, Scirus, PsycINFO, LILACS, and SciELO was conducted. Inclusion criteria were papers written in English or Spanish involving samples from Spanish-speaking Latin American individuals published until 2018. Standard procedures were applied for reviewing the literature. The data related to the study sample, methodology, and procedures applied, as well as the performance obtained with the corresponding BCS, were collected and systematized. Results: Thirteen of 211 articles met the inclusion criteria. The studies primarily involved memory clinic-based samples, with the exception of two studies from an adult day-care center, one from a primary care clinic, and one from a community-based sample. All the studies originated from five of the 20 countries of LA and all used standardized diagnostic criteria for the diagnosis of dementia and MCI; however, the diagnostic protocols applied differed. Most studies reported samples with an average of 10 years of education and only one reported a sample with an average of <5 years of education. No publication to date has included an illiterate population. Although the Montreal cognitive assessment (MoCA) is the most widely-used BCS tool in LA, it is significantly influenced by education level. Conclusions: Although evidence is still limited, the findings from studies on LA populations suggest that MoCA requires cultural adaptations and different cutoff points according to education level. Moreover, the diagnostic validity of the INECO frontal screening (IFS) test should be evaluated in populations with a low level of education. Given the heterogeneity that exists in the levels of education in LA, more studies involving illiterate and indigenous populations are required.
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Affiliation(s)
- Nilton Custodio
- Research Unit, Instituto Peruano de Neurociencias, Lima, Peru.,Cognitive Decline and Dementia Diagnostic and Prevention Services Unit, Instituto Peruano de Neurociencias, Lima, Peru.,Neurology Department, Instituto Peruano de Neurociencias, Lima, Peru
| | | | - Rosa Montesinos
- Research Unit, Instituto Peruano de Neurociencias, Lima, Peru.,Cognitive Decline and Dementia Diagnostic and Prevention Services Unit, Instituto Peruano de Neurociencias, Lima, Peru
| | - Carlos Alva-Diaz
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Martin Mellado
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences and East Neuroscience Departments, University of Chile School of Medicine, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences and East Neuroscience Departments, University of Chile School of Medicine, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), University of Chile School of Medicine, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile.,Neurology Unit, Department of Medicine, Alemana Clinic, Universidad del Desarrollo, Santiago, Chile
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24
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Bruijnen CJWH, Dijkstra BAG, Walvoort SJW, Budy MJJ, Beurmanjer H, De Jong CAJ, Kessels RPC. Psychometric properties of the Montreal Cognitive Assessment (MoCA) in healthy participants aged 18-70. Int J Psychiatry Clin Pract 2020; 24:293-300. [PMID: 32271127 DOI: 10.1080/13651501.2020.1746348] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: The Montreal Cognitive Assessment (MoCA) is a cognitive screen, available in three alternate versions. Aims of the current study were to examine the effects of age, education and intelligence on MoCA performance and to determine the alternate-form equivalence and test-retest reliability of the MoCA, in a group of healthy participants.Method: In 210 participants, two MoCA versions and an estimator for premorbid intelligence were administered at two time points.Results: Age, education and estimated premorbid intelligence correlated significantly with the total score (MoCA-TS) and the Memory Index Score (MoCA-MIS). Systematic differences between MoCA version 7.1 and alternate versions 7.2 and 7.3 were only found for the items animal naming, abstract reasoning and sentence repetition. Test-retest reliability of the MoCA-TS was good between 7.1 and 7.2 (ICC: 0.64) and excellent between 7.1 and 7.3 (ICC: 0.82). For the MoCA-MIS, coefficients were poor (ICC: 0.32) to fair (ICC: 0.48), respectively.Conclusion: Adequate norms are needed that take the effects of age, education and intelligence on MoCA performance into account. All three MoCA versions are largely equivalent based on MoCA-TS and the test-retest reliabilities show that this score is suitable to monitor cognitive change over time. Comparisons of the domain-specific scores should be interpreted with caution.Key pointsThe MoCA total score is a reliable cognitive measure.All three MoCA versions are largely equivalent.Age, education and intelligence are predictors of MoCA performance in healthy participants.Future studies should focus on collecting normative data for age, education and intelligence for use in clinical practice.
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Affiliation(s)
- Carolien J W H Bruijnen
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Boukje A G Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands.,Novadic-Kentron, Addiction Care Center, Vught, The Netherlands
| | - Serge J W Walvoort
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands
| | - Manon J J Budy
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Harmen Beurmanjer
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands.,Novadic-Kentron, Addiction Care Center, Vught, The Netherlands
| | - Cor A J De Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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25
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Amatneeks TM, Hamdan AC. Sensitivity and specificity of the Brazilian version of the Montreal Cognitive Assessment - Basic (MoCA-B) in chronic kidney disease. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 41:327-333. [PMID: 31967193 DOI: 10.1590/2237-6089-2018-0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/02/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. OBJECTIVE To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment - Basic (MoCA-B) for identification of cognitive impairment in the CKD population. METHODS This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. RESULTS The MoCA-B has reliable internal consistency (Cronbach's alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. CONCLUSIONS The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.
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26
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Serrano CM, Sorbara M, Minond A, Finlay JB, Arizaga RL, Iturry M, Martinez P, Heinemann G, Gagliardi C, Serra A, Magliano FC, Yacovino D, Rojas MMEY, Ruiz AS, Graviotto HG. Validation of the Argentine version of the Montreal Cognitive Assessment Test (MOCA): A screening tool for Mild Cognitive Impairment and Mild Dementia in Elderly. Dement Neuropsychol 2020; 14:145-152. [PMID: 32595883 PMCID: PMC7304280 DOI: 10.1590/1980-57642020dn14-020007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The MoCA is a brief useful test to diagnose mild cognitive impairment (MCI) and mild dementia (MD). To date, no Argentine cross-cultural adapted validations of the Spanish version have been reported. Objective To validate the MoCA in the elderly and study its usefulness in MCI and MD. Methods This study included 399 individuals over 60 years old evaluated in the Cognitive-Behavioral Department (2017-2018). Patients with<3 years of education, sensory disturbances, psychiatric disorders, or moderate-severe dementia were excluded. The control group comprised cognitively normal subjects. Participants were classified according to neuropsychological assessment and clinical standard criteria into Control, MCI or MD groups. A locally adapted MoCA (MOCA-A) was administered to the patients and controls. Results Mean educational level was 10.34 years (SD 3.5 years). MoCA-A score differed significantly among groups (p<0.0001). MoCA-A performance correlated with educational level (r: 0.406 p<0.00001). Adopting a cut-off score ≥25 (YI=0.55), the sensitivity for MCI was 84.8% and for MD 100%, with specificity of 69.7%. When adding a single point to the score in patients with ≤12 years of education, the specificity of the test reached 81%. Conclusion The MoCA-A is an accurate reliable screening test for MCI and MD in Argentina.
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Affiliation(s)
- Cecilia M Serrano
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina.,Laboratorio de Memoria y Equilibrio, Buenos Aires, Argentina
| | - Marcos Sorbara
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Alexander Minond
- Carrera Interdisciplinaria de Especialización en Neuropsicología Clínica, Facultad de Psicologia, UBA, Buenos Aires, Argentina
| | - John B Finlay
- Duke University School of Medicine, North Carolina, USA
| | - Raul L Arizaga
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Monica Iturry
- Carrera de Investigador Clínico del Gobierno de la Ciudad de Buenos Aires, Argentina
| | - Patricia Martinez
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Gabriela Heinemann
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Celina Gagliardi
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Andrea Serra
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Florencia Ces Magliano
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
| | - Darío Yacovino
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina.,Laboratorio de Memoria y Equilibrio, Buenos Aires, Argentina
| | | | - Adelaida Susana Ruiz
- Carrera Interdisciplinaria de Especialización en Neuropsicología Clínica, Facultad de Psicologia, UBA, Buenos Aires, Argentina
| | - Héctor Gastón Graviotto
- Neurología Cognitiva y Neuropsicología. Hospital Dr. Cesar Milstein, Buenos Aires, Argentina
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Cesar KG, Yassuda MS, Porto FHG, Brucki SMD, Nitrini R. MoCA Test: normative and diagnostic accuracy data for seniors with heterogeneous educational levels in Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:775-781. [DOI: 10.1590/0004-282x20190130] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/01/2019] [Indexed: 11/21/2022]
Abstract
ABSTRACT The Montreal Cognitive Assessment (MoCA) has been described as a good tool to detect cognitive impairment. The ideal MoCA cutoff score is still under debate. The aim was to provide MoCA norms and accuracy data for seniors with a lower education level, including illiterates. Methods: Data originated from an epidemiological study conducted in the municipality of Tremembe, Brazil. The Brazilian MoCA test was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia and 135 were classified as having cognitive impairment no dementia (CIND). Results: The total scores varied significantly according to age and education among the three diagnostic groups: CN, CIND and dementia (p < 0.001). To distinguish participants with CN from dementia, the best MoCA cutoff was 15 points (sensitivity 90%, specificity 77%) and to differentiate those with CN from CIND, the MoCA cutoff was 19 points (sensitivity 84%, specificity 49%). Those scores varied according to education level. Conclusions: The MoCA test did not have a high accuracy for detecting CIND in the population with a low educational level. Nevertheless, this tool may be used to detect dementia, especially in individuals with more than five years of education, if a lower cutoff score is adopted.
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