Educational level and its Association with the domains of the Montreal Cognitive Assessment Test

Borda, Miguel Germán; Reyes‐Ortiz, Carlos A.; Pérez‐Zepeda, Mario Ulises; Patiño-Hernández, Daniela; Gómez-Arteaga, Camilo; Cano-Gutiérrez, Carlos Alberto

doi:10.1080/13607863.2018.1488940

Cited by 30 publications

(22 citation statements)

References 20 publications

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“…Similar to previous reports, 23, 24 our study confirmed the association between level of education and CDT score. An adjusted cut‐off score should be considered to increase the accuracy of score interpretations in patients with >6 years of education.…”

Section: Discussionsupporting

confidence: 92%

The Six‐item Clock‐Drawing Scoring System: a rapid screening for cognitive impairment in Parkinson's disease

et al. 2020

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Background Cognitive impairment, characterised by predominant executive dysfunction and visuospatial deficit, is frequently observed in Parkinson's disease (PD) and may lead to mild cognitive impairment (PD‐MCI) and dementia (PD‐D). The clock‐drawing test (CDT) is a rapid cognitive evaluation that is appropriate for screening frontoparietal lobe dysfunction. This study aimed to evaluate the screening performance of the Six‐item Clock‐Drawing Scoring System (6‐CDSS) in detecting cognitive impairment in PD patients. Methods A retrospective analysis of free‐drawn clocks from 136 PD patients was performed. The presence of cognitive impairment and dementia was documented by neurologists according to the standard diagnostic criteria. Diagnostic performance and the optimal screening cut‐off scores for cognitive impairment and dementia using the 6‐CDSS were determined. Results One hundred and thirteen patients were documented as having PD with cognitive impairment (PD‐CI). Of those, 39 were diagnosed as probable PD‐D and 74 with PD‐MCI. The optimal screening cut‐off scores for PD‐CI were 4/5 and 1/2 for probable PD‐D. The area under the receiver operating characteristic curve was 0.88 and 0.91, respectively. Multiple regression analysis revealed that low education levels, poor activity of daily living, and older age were associated with low 6‐CDSS scores. Conclusions CDT scoring using the 6‐CDSS is a reliable system to screen cognitive impairment in PD and may serve as a simple screening tool for PD‐D in clinical practice.

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Section: Discussionsupporting

confidence: 92%

The Six‐item Clock‐Drawing Scoring System: a rapid screening for cognitive impairment in Parkinson's disease

et al. 2020

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“…Our results concur with another study that education could affect the MoCA scores 16 . The participants with a total of education less than 12 years scored lower in MoCA.…”

Section: Interpretationssupporting

confidence: 93%

“…This study used a conservative MoCA cut-off score of 23 and adjusted the scores for education (+ 1 point if years of education ≤ 12 years) to lower the false positive rate 19 , despite the reported concern of possible lower sensitivity to identify MCI 20 , in order to reach a better diagnostic accuracy compared to the original cut-off score of 26/30 21 . The level of cognitive impairment was then categorized as mild cognitive impairment (scores between [18][19][20][21][22], mild dementia (11)(12)(13)(14)(15)(16)(17), moderate dementia (6-10), and severe dementia (< 6).…”

Section: Study Aim and Designmentioning

confidence: 99%

“…The MoCA has also been demonstrated to be effective as a screening tool for cognitive impairment in various clinical settings, including in older patients with cancer 13 , in amnesic patients 14 , and in the elderly at the primary health care level 15 . One drawback in using the MoCA is that the test scores could be affected by years of education 16 , and despite the one-point correction for less than grade 12 education, the suggested cut-off score of 26 to diagnose MCI may over-diagnose MCI in patients with less formal education [17][18] .…”

Section: Introductionmentioning

confidence: 99%

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The value of routine screening for cognitive impairment in a primary care setting: a retrospective cross-sectional study

Qiu¹,

Chang²,

Chang³

2021

Preprint

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BACKGROUND Cognitive impairment is not uncommon among older individuals but is often underdiagnosed in the primary care settings. Our objective is to identify the prevalence of varying degrees of cognitive impairment in older adults in urban primary care clinics. METHODS This cross-sectional study was undertaken from May to July 2019. The Montreal Cognitive Assessment (MoCA) was administered to participants 65-year and older who were seen during a routine visit to our primary care clinic. The participants were recruited on a sequential basis. The primary outcomes of the study were the MoCA scores, and the level of cognitive impairment, if any, indicated by the scores. RESULTS Out of the 133 participants, 46 (34.6%) scored below the cut-off of 23 out of 30, indicating certain level of cognitive impairment. The mean MoCA score was 23.24. The average age was 75.19 years. Average years of education was 12.6. In our cohort, higher MoCA scores were associated with increased years of education. MoCA scores were not inversely correlated with age. Language proficiency in the MoCA test version administered had significant impact on the MoCA scores. CONCLUSIONS A relatively high prevalence of cognitive impairment was found in our cohort. Further study is required to accurately assess the prevalence of cognitive impairment in general population. However, the findings attest the value of routine screening for cognitive impairment in primary care settings and warrant routine screening of older individuals to help in early detection of mild cognitive impairment.

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“…12 Although diverse cognitive assessment tools have been developed to screen for the decline in cognitive functions, such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), educational level has implications with regards to the skills that are assessed using these instruments. 13 Therefore, the prevalence of cognitive decline may be overestimated, especially in low-and middle-income countries, such as Brazil, as a good performance on cognitive screening tests is influenced by schooling. 12 Evidence points to a deficit in the communication of brain regions underlying the performance on cognitive tasks among older adults with a low educational level.…”

Section: Introductionmentioning

confidence: 99%

Cognitive performance of older adults with a low level of education with and without depression

Bomfim

Chagas

Leal

et al. 2021

Dement. neuropsychol.

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ABSTRACT. Major depression can develop in individuals aged 60 years or older and is commonly associated with cognitive decline in this population, especially the domains of working memory, attention, executive functions, and processing speed. Schooling is a protective factor with regard to cognitive decline. Objective: To compare the cognitive performance of community-dwelling older adults with a low level of schooling with and without major depression. Methods: A descriptive, analytical, cross-sectional study was conducted with 22 community-dwelling older adults with depression and 187 without depression. The following assessment tools were employed: Mini Mental Health Examination, Brief Cognitive Screening Battery, Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), Digit Span Test (forward and backward), and an object similarity test. Results: No statistically significant differences were found between the groups with and without depression on any of the tests. Conclusions: This study demonstrated that there are no differences in the cognitive performance of older people with and without depression on neurocognitive tests commonly used in clinical practice. Future studies with different designs and methods as well as specific tests for older people with a low level of schooling could assist in the understanding of these relations and the mechanisms involved.

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Educational level and its Association with the domains of the Montreal Cognitive Assessment Test

Cited by 30 publications

References 20 publications

The Six‐item Clock‐Drawing Scoring System: a rapid screening for cognitive impairment in Parkinson's disease

The Six‐item Clock‐Drawing Scoring System: a rapid screening for cognitive impairment in Parkinson's disease

The value of routine screening for cognitive impairment in a primary care setting: a retrospective cross-sectional study

Cognitive performance of older adults with a low level of education with and without depression

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