Validity of the Montreal Cognitive Assessment in the Detection of Mild Cognitive Impairment in Parkinson’s Disease


Authors: O. Bezdíček 1;  J. Michalec 2;  T. Nikolai 1;  H. Štěpánková 3;  E. Panenková 3;  P. Harsa 2;  P. Havránková 1;  J. Roth 1;  M. Kopeček 3,4;  E. Růžička 1
Authors‘ workplace: Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze 1;  Psychiatrická klinika 1. LF UK a VFN v Praze 2;  Psychiatrické centrum Praha 3;  Klinika psychiatrie 3. LF UK v Praze 4
Published in: Cesk Slov Neurol N 2014; 77/110(1): 47-53
Category: Original Paper

Overview

Objective:
To establish psychometric properties of the Montreal Cognitive Assessment (MoCA) with respect to detecting mild cognitive impairment in Parkinson’s disease (PD-MCI).

Introduction:
MCI is considered a transitional stage between normal cognitive functioning and dementia. The MoCA has recently been recommended as one of the standard tools for the diagnosis of PD-MCI. However, its detection potential in the Czech population has not been demonstrated.

Methods:
A sample of 80 patients with PD was administered the MoCA and a neuropsychological battery with criteria operationalized for MCI-deficits. Thirty nine of these patients (PD-MCI sample) were age and education-matched to a control sample (CS). ROC analysis was used to ascertain classification statistics (discriminative validity) of the MoCA as a diagnostic instrument.

Results:
The MoCA total score was significantly different between PD-MCI and CS (p = 0.006). Delayed recall was the most differentiating MoCA subscore (p < 0.001). The 28/29 scores were identified as an optimal screening MoCA cut-off to discriminate PD-MCI from CS was (sensitivity = 0.90, specificity = 0.32; positive and negative predictive value = 0.57 and 0.76, respectively). We constructed a regression equation based on a large control sample of the Czech population (n = 268) to estimate the MoCA’s age and education-specific performance more accurately.

Conclusion:
Despite the group differences between PD-MCI and CS, our results show that MoCA has an unsatisfactory detection potential for an individual diagnosis of PD-MCI. A comprehensive neuropsychological battery is thus recommendable.

Key words:
validity – mild cognitive impairment – diagnostic criteria – Parkinson’s disease – Montreal Cognitive Assessment

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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Labels
Paediatric neurology Neurosurgery Neurology

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