The Montreal cognitive assessment as a cognitive screening tool in sickle cell disease: Associations with clinically significant cognitive domains

Early, Macy L.; Linton, Elizabeth A.; Bosch, Allison; Campbell, Timothy; Hill‐Briggs, Felicia; Pecker, Lydia H.; Lance, Eboni I.; Lanzkron, Sophie

doi:10.1111/bjh.18188

Cited by 10 publications

(7 citation statements)

References 44 publications

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“…In our study, the prevalence of HL that is below the expected standards was more than twice that of the general population, a finding that is in line with prior work in SCD 12,15,17 . Our results expand on prior work that demonstrated an association between results from an early detection cognitive screening tool and HL in adults with SCD 39 . The implications of our results, and that of other colleagues, are that any educational material, decision tool, or informed consent with complex concepts should account for the HL and intellectual functioning of the targeted SCD group, particularly adolescents and young adults.…”

Section: Discussionsupporting

confidence: 90%

“…12,15,17 Our results expand on prior work that demonstrated an association between results from an early detection cognitive screening tool and HL in adults with SCD. 39 The implications of our results, and that of other colleagues, are that any educational material, decision tool, or informed consent with complex concepts should account for the HL and intellectual functioning of the targeted SCD group, particularly adolescents and young adults. In other chronic hematologic diseases such as hemophilia, discrete choice experiments 40 and use of multimodal and multimedia consenting process have been suggested…”

Section: Discussionmentioning

confidence: 74%

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Health literacy correlates with abbreviated full‐scale IQ in adolescent and young adults with sickle cell disease

Bhatt

Calhoun

Longoria

et al. 2023

Pediatric Blood & Cancer

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Introduction: Sickle cell disease (SCD) is a chronic condition with progressive neurocognitive deficits. Health literacy (HL) is essential during adolescence and young adulthood, as the transition to adult care requires healthcare decisions. HL is known to be low in SCD; however, relation between general cognitive ability and HL has not been investigated. Methods: This cross-sectional study included adolescent and yound adults (AYAs) with SCD from two institutions. Logistic regression measured the association between HL, measured by the Newest Vital Sign tool, and general cognitive ability, measured with abbreviated full-scale intelligence quotient (FSIQ) on the Wechsler Abbreviated Scale of Intelligence. Results: Our cohort contained 93 participants at two sites: 47 (51%) at Memphis, TN and 46 (49%) at St. Louis, MO, ranging from ages 15-45 years (mean = 21 years) and with a majority (70%) possessing a high school education or greater. Only 40/93 participants (43%) had adequate HL. Lower abbreviated FSIQ (p < .0001) and younger age at assessment (p = .0003) were associated with inadequate HL.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 74%

Health literacy correlates with abbreviated full‐scale IQ in adolescent and young adults with sickle cell disease

Bhatt

Calhoun

Longoria

et al. 2023

Pediatric Blood & Cancer

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“…The need for a more fine-grained adjustment for age, sex, and education in interpreting an individual’s performance of the MoCA has become even more important as the MoCA is increasingly being used in a variety of patient samples. While originally developed for the detection of MCI and dementia due to Alzheimer’s disease, the MoCA has been studied to assess cognitive deficits in patients with a variety of medical conditions [ 12 ], including HIV [ 13 ], Parkinson’s disease [ 14 ], multiple sclerosis [ 15 ], stroke [ 16 ], frontotemporal dementia [ 17 ], substance-related cognitive disorders [ 18 , 19 ], cardiac arrest [ 20 ], fibromyalgia [ 21 ], Huntington’s disease [ 22 ], syncope and unexpected falls [ 23 ], cerebellar disease [ 24 ], schizophrenia [ 25 ], sickle cell disease [ 26 ], type 2 diabetes [ 27 ], and COVID-19 [ 28 ]. Many of these conditions affect younger adults, who may perform above established cut-off scores based on samples of older individuals even when cognitive impairment is present.…”

Section: Introductionmentioning

confidence: 99%

Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91

Kessels

Vent

Bruijnen

et al. 2022

JCM

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(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18–91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.

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“…As education influences on cognitive performance, sensitive cognitive tests are likely to be associated with educational attainment. Yet, patients with high educational attainment remain vulnerable to cognitive impairment and also demand sociocultural and/or pharmacological interventions [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Montreal cognitive assessment in Brazilian adults with sickle cell disease: The burdens of poor sociocultural background

Junqueira Fleury Silva,

Martins Silva,

Machado de Campos

et al. 2024

eJHaem

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Sickle cell disease (SCD) patients are at higher risk of developing silent cerebral infarcts and overt stroke, which may reflect cognitive impairment, functional limitations, and worse quality of life. The cognitive function of Brazilian adult SCD patients (n = 124; 19–70 years; 56 men; 79 SS, 28 SC, 10 S/β0, 7 S/β+) was screened through Montreal Cognitive Assessment (MoCA) and correlated the results with possible predictive factors for test performance, including sociocultural, clinical, laboratory data and brain imaging. The Median MoCA score was 23 (8–30); 70% had a 25‐or‐less score, suggesting some level of cognitive impairment. There were no significant associations between MoCA results and any clinical or laboratory data in SS and SC patients; however, a significant correlation (P = 0.03) with stroke was found in HbS/β‐thalassemic patients. Correlations were further detected according to sociodemographic conditions, such as age (r = −0.316; P < 0.001), age at first job (r = 0.221; P = 0.018), personal (r = 0.23; P = 0.012) and per capita familiar incomes (r = 0.303; P = 0.001), personal (r = 0.61; P = 0), maternal (r = 0.536; P = 0), and paternal educational status (r = 0.441; P = 0). We further sought independent predictors of performance using multivariable regressions and increased education was an independent predictor of better scores in MoCA (0.8099, 95% confidence interval [CI]: 0.509–1.111). Brain imaging analysis showed significant and progressive atrophy in important cerebral areas related to memory, learning, and executive function. These data point to the high prevalence and impact of cognitive decline in adult SCD patients, mirrored in brain atrophic areas. It is also possible to observe the influence of sociodemographic conditions on patients’ cognitive performances and the need for creating focused therapeutic plans that address these deficiencies. Moreover, the absence of a significant correlation of MoCA values with stroke in the SS and SC groups may be related to the worst sociocultural and economic conditions of the Brazilian African descent population, in which the impact of low educational stimulation on cognitive function can outweigh even the anatomical damage caused by the disease.

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The Montreal cognitive assessment as a cognitive screening tool in sickle cell disease: Associations with clinically significant cognitive domains

Cited by 10 publications

References 44 publications

Health literacy correlates with abbreviated full‐scale IQ in adolescent and young adults with sickle cell disease

Health literacy correlates with abbreviated full‐scale IQ in adolescent and young adults with sickle cell disease

Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91

Montreal cognitive assessment in Brazilian adults with sickle cell disease: The burdens of poor sociocultural background

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