Validity of the Montreal Cognitive Assessment (MoCA) as a Screening Test for Mild Cognitive Impairment (MCI) in a Cardiovascular Population
Validity of the Montreal Cognitive Assessment (MoCA) as a Screening Test for Mild Cognitive Impairment (MCI) in a Cardiovascular Population
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DOI：
10.1177/0891988710390813
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发表时间：
2011-03-01
影响因子：
2.6
通讯作者：
Stewart, S.
中科院分区：
文献类型：
--
作者：
McLennan, S. N.;Mathias, J. L.;Stewart, S.
虽然在有心血管疾病和危险因素的人群中，轻度认知障碍(MCI)的发生率相对较高，但在这一患者群体中，MCI的筛查测试尚未得到评估。这项研究调查了110名来自医院心血管门诊的患者(平均年龄67.9+/-11.7岁，其中60%为女性)使用蒙特利尔认知评估(MoCA)工具检测MCI的敏感性和特异性。在这组人中，MoCA的平均成绩相对较低(22.8+/-3.8)，72.1%的参与者得分低于推荐的认知障碍分界值(<；26)。使用神经心理评估成套筛查模块(NAB-SM)确定MCI的存在。遗忘型MCI和多域型MCI均可识别。本组检测MCI的最佳MoCA临界值为24。在此临界点上，MoCA检测遗忘性MCI的敏感性为100%，而多域MCI的敏感性为83.3%。遗忘型MCI和多域MCI的特异度分别为50.0%和52%。MoCA的低特异度表明，在MCI总体患病率较低的情况下，它作为MCI的筛查试验的价值有限。
While rates of mild cognitive impairment (MCI) are relatively high in populations with cardiovascular diseases and risk factors, screening tests for MCI have not been evaluated in this patient group. This study investigated the sensitivity and specificity of the Montreal Cognitive Assessment (MoCA) tool for detecting MCI in 110 patients (mean age 67.9 +/- 11.7 years; 60% female) recruited from hospital cardiovascular outpatient clinics. Mean MoCA performance was relatively low (22.8 +/- 3.8) in this group, with 72.1% of participants scoring below the recommended cutoff for cognitive impairment (< 26). The presence of MCI was determined using the Neuropsychological Assessment Battery Screening Module (NAB-SM). Both amnestic MCI and multiple-domain MCI were identified. The optimum MoCA cutoff for detecting MCI in this group was < 24. At this cutoff, the MoCA's sensitivity for detecting amnestic MCI was 100% and for multiple-domain MCI it was 83.3%. Specificity rates for amnestic MCI and multiple-domain MCI were 50.0% and 52% respectively. The poor specificity of the MoCA suggests that it will have limited value as a screening test for MCI in settings where the overall prevalence of MCI is low.