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

Czech version

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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