Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease
ABSTRACT Background: The Montreal Cognitive Assessment (MoCA) is a short global cognitive scale, and some studies suggest it is useful for evaluating cognition in patients with Parkinson's disease (PD). However, its accuracy has been questioned in studies involving patients with low education. Objective: We sought to assess whether some of the MoCA subtests contribute to the low accuracy of the test. Methods: We performed a cross-sectional retrospective analysis of clinical data in a cohort of 71 patients with PD, most with less than 8 years of education. Patients were examined using the MDS-UPDRS, Hoehn and Yahr and the MoCA. The data were analyzed using mainly descriptive statistics. Results: We analyzed the data of 66 patients that were not demented according to the clinical evaluation and classified them using the proposed cut-off MoCA scores for diagnosis of MCI and dementia. Thirteen patients (19.7%) were classified as having normal cognition, 24 (36.3%) MCI and 29 (43.9%) dementia. Patients with dementia had longer disease duration (p=0.016) and lower education (p=0.0001). Total MoCA scores had a an almost normal distribution with a wide range of scores and only one maximum score. Performance on the MoCA was highly correlated with education (correlation coefficient=0.66, p=0.0001). At least five of the 10 MoCA subtests showed significant floor effects. Conclusion: We believe that some of the MoCA subtests may be too difficult to be completed by PD patients with low educational level, thus contributing to the test's poor diagnostic accuracy.
Main Authors: | , , , , , , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento
2016
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642016000400333 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S1980-57642016000400333 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S1980-576420160004003332016-12-19Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's diseaseTumas,VitorBorges,VanderciBallalai-Ferraz,HenriqueZabetian,Cyrus P.Mata,Ignácio F.Brito,Manuelina M.C.Foss,Maria PaulaNovaretti,NathaliaSantos-Lobato,Bruno Lopes MoCA validity Parkinson's disease mild cognitive impairment dementia cognitive assessment ABSTRACT Background: The Montreal Cognitive Assessment (MoCA) is a short global cognitive scale, and some studies suggest it is useful for evaluating cognition in patients with Parkinson's disease (PD). However, its accuracy has been questioned in studies involving patients with low education. Objective: We sought to assess whether some of the MoCA subtests contribute to the low accuracy of the test. Methods: We performed a cross-sectional retrospective analysis of clinical data in a cohort of 71 patients with PD, most with less than 8 years of education. Patients were examined using the MDS-UPDRS, Hoehn and Yahr and the MoCA. The data were analyzed using mainly descriptive statistics. Results: We analyzed the data of 66 patients that were not demented according to the clinical evaluation and classified them using the proposed cut-off MoCA scores for diagnosis of MCI and dementia. Thirteen patients (19.7%) were classified as having normal cognition, 24 (36.3%) MCI and 29 (43.9%) dementia. Patients with dementia had longer disease duration (p=0.016) and lower education (p=0.0001). Total MoCA scores had a an almost normal distribution with a wide range of scores and only one maximum score. Performance on the MoCA was highly correlated with education (correlation coefficient=0.66, p=0.0001). At least five of the 10 MoCA subtests showed significant floor effects. Conclusion: We believe that some of the MoCA subtests may be too difficult to be completed by PD patients with low educational level, thus contributing to the test's poor diagnostic accuracy.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e EnvelhecimentoDementia & Neuropsychologia v.10 n.4 20162016-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642016000400333en10.1590/s1980-5764-2016dn1004013 |
institution |
SCIELO |
collection |
OJS |
country |
Brasil |
countrycode |
BR |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-br |
tag |
revista |
region |
America del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Tumas,Vitor Borges,Vanderci Ballalai-Ferraz,Henrique Zabetian,Cyrus P. Mata,Ignácio F. Brito,Manuelina M.C. Foss,Maria Paula Novaretti,Nathalia Santos-Lobato,Bruno Lopes |
spellingShingle |
Tumas,Vitor Borges,Vanderci Ballalai-Ferraz,Henrique Zabetian,Cyrus P. Mata,Ignácio F. Brito,Manuelina M.C. Foss,Maria Paula Novaretti,Nathalia Santos-Lobato,Bruno Lopes Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
author_facet |
Tumas,Vitor Borges,Vanderci Ballalai-Ferraz,Henrique Zabetian,Cyrus P. Mata,Ignácio F. Brito,Manuelina M.C. Foss,Maria Paula Novaretti,Nathalia Santos-Lobato,Bruno Lopes |
author_sort |
Tumas,Vitor |
title |
Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
title_short |
Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
title_full |
Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
title_fullStr |
Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
title_full_unstemmed |
Some aspects of the validity of the Montreal Cognitive Assessment (MoCA)for evaluating cognitive impairment in Brazilian patients with Parkinson's disease |
title_sort |
some aspects of the validity of the montreal cognitive assessment (moca)for evaluating cognitive impairment in brazilian patients with parkinson's disease |
description |
ABSTRACT Background: The Montreal Cognitive Assessment (MoCA) is a short global cognitive scale, and some studies suggest it is useful for evaluating cognition in patients with Parkinson's disease (PD). However, its accuracy has been questioned in studies involving patients with low education. Objective: We sought to assess whether some of the MoCA subtests contribute to the low accuracy of the test. Methods: We performed a cross-sectional retrospective analysis of clinical data in a cohort of 71 patients with PD, most with less than 8 years of education. Patients were examined using the MDS-UPDRS, Hoehn and Yahr and the MoCA. The data were analyzed using mainly descriptive statistics. Results: We analyzed the data of 66 patients that were not demented according to the clinical evaluation and classified them using the proposed cut-off MoCA scores for diagnosis of MCI and dementia. Thirteen patients (19.7%) were classified as having normal cognition, 24 (36.3%) MCI and 29 (43.9%) dementia. Patients with dementia had longer disease duration (p=0.016) and lower education (p=0.0001). Total MoCA scores had a an almost normal distribution with a wide range of scores and only one maximum score. Performance on the MoCA was highly correlated with education (correlation coefficient=0.66, p=0.0001). At least five of the 10 MoCA subtests showed significant floor effects. Conclusion: We believe that some of the MoCA subtests may be too difficult to be completed by PD patients with low educational level, thus contributing to the test's poor diagnostic accuracy. |
publisher |
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento |
publishDate |
2016 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642016000400333 |
work_keys_str_mv |
AT tumasvitor someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT borgesvanderci someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT ballalaiferrazhenrique someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT zabetiancyrusp someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT mataignaciof someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT britomanuelinamc someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT fossmariapaula someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT novarettinathalia someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease AT santoslobatobrunolopes someaspectsofthevalidityofthemontrealcognitiveassessmentmocaforevaluatingcognitiveimpairmentinbrazilianpatientswithparkinsonsdisease |
_version_ |
1756434484657389568 |