A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?
A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?
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DOI：
10.1017/s1041610215001982
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发表时间：
2016-05-01
影响因子：
7
通讯作者：
Aprahamian, Ivan
中科院分区：
文献类型：
--
作者：
Cecato, Juliana Francisco;Martinelli, Jose Eduardo;Aprahamian, Ivan
工作背景：有必要继续探索蒙特利尔认知评估（莫卡）等关键认知筛查测试的心理测量学特征，以尽早诊断认知衰退，并满足日益增长的涉及轻度认知障碍（MCI）参与者的临床试验需求。本研究的主要目的是评估哪些莫卡子测试可以最好地区分健康对照组（HC），MCI参与者，和阿尔茨海默病（AD）。方法：136名老年人的横断面分析超过四年的教育。所有参与者都接受了详细的临床、实验室和神经影像学评价。对所有参与者进行莫卡、简易精神状态检查（MMSE）、剑桥认知检查（CAMCOG）、老年抑郁量表（GDS）和功能活动问卷（FAQ）。结果：HC、MCI和AD的莫卡总分中位数分别为27、23和18（p < 0.001）。MCI和HC受试者在单词重复、倒数数字、序列7、短语、语言流畅性、抽象和单词回忆方面存在差异（p < 0.001）。MCI组与AD组在画时钟、犀牛命名、五个词的延迟回忆和定向方面差异有显著性（p < 0.001）。简化版莫卡仅包含这些项目并不能提高MCI与HC（p = 0.076）或MCI与AD（p = 0.119）之间的准确性。结论：并非所有莫卡子测试都是MCI临床诊断的基础。简化版莫卡并没有增加诊断的准确性。
Background: It is necessary to continue to explore the psychometric characteristics of key cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) to diagnose cognitive decline as early as possible and to attend to the growing need of clinical trials involving mild cognitive impairment (MCI) participants. The main aim of this study was to assess which MoCA subtests could best discriminate between healthy controls (HC), participants with MCI, and Alzheimer's disease (AD).Methods: Cross-sectional analysis of 136 elderly with more than four years of education. All participants were submitted to detailed clinical, laboratory, and neuroimaging evaluation. The MoCA, Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), Geriatric Depression Scale (GDS), and Functional Activities Questionnaire (FAQ) were applied to all participants. The MoCA test was not used in the diagnostic procedure.Results: Median MoCA total scores were 27, 23 and 18 for HC, MCI, and AD, respectively (p < 0.001). Word repetition, inverse digits, serial 7, phrases, verbal fluency, abstraction, and word recall discriminated between MCI and HC participants (p < 0.001). The clock drawing, the rhino naming, delayed recall of five words and orientation discriminated between patients with MCI and AD (p < 0.001). A reduced version of the MoCA with only these items did not improve accuracy between MCI and HC (p = 0.076) or MCI and AD (p = 0.119).Conclusions: Not all MoCA subtests might be fundamental to clinical diagnosis of MCI. The reduced versions of MoCA did not add diagnostic accuracy.