Brief Screening for Mild Cognitive Impairment in Subcortical Ischemic Vascular Disease: A Comparison Study of the Montreal Cognitive Assessment with the Mini-Mental State Examination

Abstract

Background and Purpose: To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). Methods: Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. Results: After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). Conclusions: The MoCA detected subcortical VaMCI better than the MMSE.

Analysis of Cerebral Blood Flow with Single Photon Emission Computed Tomography in Mild Subcortical Ischemic Vascular Dementia

“…Consistent patterns of subcortical shape abnormalities also supported sVCI as a prodromal stage on a continuum from normal controls to SIVaD [19]. Screening tools for this transitional state or mild forms may provide a critical opportunity for disease-modifying therapy [20]. The mean duration of cognitive impairment in the SIVaD patients was relatively short at 14.12±6.89 months, in keeping with the enrollment criteria of only mild forms of the disease; Swanwick et al found that dementia severity was correlated with duration of symptoms [21].…”

Feasibility of a Multiple-Choice Mini Mental State Examination for Chronically Critically Ill Patients

“…Such a test seemed too simple and not specific enough to enable detection and distinction of slight cognitive dysfunctions. Since ICU patients frequently suffer 29 ( (33), another recent broad ranging work reported that the MMSE is the instrument most extensively studied (34). The present study aimed not to determine the best test for critically ill patients but to allow a better follow-up of their cognitive function even after ICU discharge.…”

Screening of cognitive impairment in the old and old-old population with the 3-CT scale

“…Чувствительность и специфичность MMSE и МоСА в разных возрастных группах вариабельны и зависят от нейропсихологического профиля и уровня образования [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Кроме того, большин-ство шкал адаптировано к амбулаторной оценке и их использование в условиях стационара может быть затруднено.…”

“…По шка-ле MMSE при пороге отсечения в 24 балла у паци-ентов с выраженными когнитивными нарушения-ми чувствительность составила только 46%. Эти данные в целом согласуются с результатами работ других авторов и ставят под сомнение возможность использование данного теста для скрининга на когнитивное снижение [12,13].…”