1/2/2024 0 Comments Moca cognitive testThe cognitively impaired group was further classified by subtype (attention/working memory, executive, episodic memory, language, visuospatial) according to the tests within each domain with a score ≥ 1.5 standard deviations below age and education matched normative values. Cognitive impairment was defined by scores ≥ 1.5 standard deviations below age and education matched normative values on at least two tests. Using published criteria, participants were categorized as PD without cognitive impairment (n=45) or PD with cognitive impairment (n=40). The neuropsychological battery consisted of at least 2 tests in five cognitive domains: (1) Attention/Working Memory: Trail Making Test A&B, Wechsler Memory Scale – Third Edition Digit Span (forward and backwards), and the Golden Stroop (2) Executive Function: Symbol Digit Modalities Test (Written and Verbal) and Controlled Word Association Test (FAS) (3) Episodic Memory: California Verbal Learning Test-II and Brief Visuospatial Memory Test-Revised (4) Language: Boston Naming Test – Short Form A, Semantic Fluency (animals), Delis-Kaplan Executive Function System Boys Names and Category Switching (Fruits and Furniture) (5) Visuospatial: Hooper Visual Organization Test and Judgement of Line Orientation – Long Form V. With this in mind, we studied the accuracy, sensitivity, and specificity of the MoCA to predict domain-specific PD cognitive impairments.Įach participant underwent a clinical evaluation that included a medical history, a physical examination, a Movement Disorders Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale including Hoehn and Yahr stage, a depression screening (Beck Depression Inventory-II), and comprehensive neuropsychological evaluation, including the MoCA. However, without knowing the applicability of the MoCA subsections to domain-specific impairments these studies are all limited to simple general cognitive outcomes. Further, one advantage of the MoCA over most other cognitive tests is that it is available in 55 different languages and could therefore be used in large multicultural research settings. For instance, the MoCA is likely to be the only cognitive data available for retrospective PD studies reliant on chart review. However, many clinicians and researchers do not have access to the recommended full neuropsychological battery, and therefore would benefit from guidelines on how to interpret the MoCA subsections when this is the only test available. Currently, the MoCA is only used for level I diagnosis and not domain-specific diagnosis. Īlthough the sensitivity and specificity of the MoCA has been established for identifying global cognitive impairment in PD, it is unclear how sensitive and specific the MoCA is at identifying impairment within individual cognitive domains. For instance, studies that include a full neuropsychological battery have found multi-domain cognitive impairment, rather than single-domain cognitive impairment, is most common and is present in up to 35% of newly diagnosed PD patients. Therefore, the MoCA is particularly useful in PD because these patients typically develop heterogeneous cognitive impairments. The high sensitivity to global impairment is in part because, unlike many other global cognitive assessments, the MoCA includes tests in five domains, including attention/working memory, executive function, episodic memory, language, and visuospatial. The Montreal Cognitive Assessment (MoCA) is a 10-minute screening tool that has been validated in detecting cognitive impairment in PD and several studies have shown that a score less than 26 (out of 30) has 90% sensitivity and 53% to 75% specificity in detecting global PD cognitive impairment. These tools are widely used in both the clinical and research settings and impairment on a scale of global cognitive abilities is the minimum requirement for level I criteria of mild cognitive impairment in PD. Global cognitive assessments are often used as screening tools to detect cognitive impairment in Parkinson’s disease (PD) patients.
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