Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson's disease
- PMID: 28215728
- PMCID: PMC5400012
- DOI: 10.1016/j.parkreldis.2017.02.008
Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson's disease
Abstract
Objective: The Montreal Cognitive Assessment (MoCA) is among the most widely adopted screening tools for cognitive impairment because it includes tests in multiple domains and is available in 55 languages. The MoCA is often the only formal cognitive assessment available when comprehensive neuropsychological testing is not practical, such as rural clinical settings or large retrospective and multi-lingual research settings. However, the MoCA domain-specific subsections have never been formally assessed for sensitivity or specificity. Therefore, in Parkinson's disease, we examined whether the subsections of the MoCA could identify cognitive impairment within specific cognitive domains.
Methods: We administered a comprehensive neuropsychological battery to 85 Parkinson's disease participants, who were then categorized as with or without cognitive impairment, with respect to global cognition and in five cognitive domains. We then assessed the domain-specific categorization of the MoCA subsections compared to the full neuropsychology battery.
Results: All MoCA subsections predicted impairment in their respective cognitive domain. However, the executive subsection showed the highest sensitivity and specificity (89.3% and 82.5%, respectively), followed by visuospatial (93.3% and 45.7%, respectively) and memory (84.6% and 56.5%, respectively).
Conclusion: The MoCA is a useful screening tool for PD global cognitive and executive functions. The MoCA is also highly sensitive to visuospatial and memory impairment, but with limited specificity and accuracy these subsections should be interpreted with caution.
Keywords: Cognitive impairment; Montreal Cognitive Assessment; Parkinson's disease; Sensitivity; Specificity.
Copyright © 2017 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Comment in
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Associations between intra-individual variability and Montreal Cognitive Assessment (MoCA) in cognitive ageing and prodromal dementia: A domain-specific perspective.Parkinsonism Relat Disord. 2018 Mar;48:102-103. doi: 10.1016/j.parkreldis.2017.11.337. Epub 2017 Nov 22. Parkinsonism Relat Disord. 2018. PMID: 29174196 No abstract available.
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Further study of the Montreal Cognitive Assessment's domain-specific metrics could allow for international data comparison and collaboration.Parkinsonism Relat Disord. 2018 Mar;48:101. doi: 10.1016/j.parkreldis.2017.11.336. Epub 2017 Nov 21. Parkinsonism Relat Disord. 2018. PMID: 29221675 No abstract available.
References
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- Dalrymple-Alford JC, MacAskill MR, Nakas CT, et al. The MoCA: Well-suited screen for cognitive impairment in Parkinson disease. Neurology. 2010;75:1717–1725. - PubMed
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- Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau A, Whitehead V, Collin I, Cummings JL. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–699. - PubMed
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