The Validity, Reliability and Clinical Utility of the Hong Kong Montreal Cognitive Assessment (HK-MoCA) in Patients with Cerebral Small Vessel Disease

Abstract

Background/Aims: To evaluate the psychometric properties of the Hong Kong Montreal Cognitive Assessment (HK-MoCA) in patients with cerebral small vessel disease (SVD). Methods: 40 SVD patients and 40 matched controls were recruited. Concurrent and criterion validity, inter-rater and test-retest reliability, internal consistency of the HK-MoCA were examined and clinical observations were made. Results: Performance on the HK-MoCA was significantly predicted by both executive (β = 0.23, p = 0.013) and non-executive (β = 0.64, p < 0.001) composite scores. It differentiated SVD patients from controls (area under the curve = 0.81, p < 0.001) with an optimal cutoff at 21/22. Reliability, internal consistency and clinical utility were good. Conclusion: The HK-MoCA is a useful cognitive screening instrument for use in SVD patients.

The Montreal Cognitive Assessment (MoCA) in Multiple Sclerosis: Relation to Clinical Features

“…The mean MoCA of 25.86 ± 2.92 in our sample was similar to a smaller sample of individuals with MS [27], 26.02± 2.30 and is in the same range as other neurologic disorders associated with mild cognitive impairment including REM Sleep Behavior Disorder [34] (n=38, 24.34 ± 3.50), or early Parkinson's disease [7] (n=100, 24.9 ±3.1), but is considerably higher than individuals with brain metastasis [36](n=40, 20.53 ± -5.15), cerebral small vessel disease [37] (n=40, 19.2 ± 4.2), Huntington's disease [9](n=53, 21 ±4.4) or Alzheimer's disease [3](n=321,13.0 4 ±6.05) [4,[7][8][9]27,[36][37][38][39].…”

Psychometric properties of Brief‐Balance Evaluation Systems Test (Brief‐BESTest) in evaluating balance performance in individuals with chronic stroke

“…The MoCA assesses cognition, which could yield a total score ranging from 0 to 30. Higher scores are indicative of better cognitive ability (Wong et al., 2009). Its intra‐rater and inter‐rater reliability (0.96 and 0.87) was good (Wong et al., 2009).…”

A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong

“…8 It was the same as the Hong Kong version: 73% sensitivity and 75% specificity for patients with small vessel disease (SVD). 13 Furthermore, the original MoCA has high level of internal consistency (Cronbach's alpha of 0.83) and test-retest reliability (correlation coefficient=0.92, P<0.001). 5 This study employed the Hong Kong version of MoCA (HK-MoCA) which has been validated in Chinese patients with cerebral SVD by Wong et al 13 The primary objective was to evaluate the HK-MoCA as a screening tool in identification of MCI and dementia in Chinese older adults, and to determine the corresponding optimal cutoff points.…”

“…For this reason, we adopted a lower level of education adjustment to 6 years of education which had been employed by studies in China, 8,10 Korea, 7 and Hong Kong. 13 Using this adjustment for education level, regression R 2 coefficient was 0.587. Thus, more than half of the variation in HK-MoCA was explained by the model.…”

“…It is commonly used to discriminate cognitive impairment due to various causes. In Hong Kong, there was only one validation study conducted by Wong et al 13 involving use of HK-MoCA in patients with cerebral SVD. They demonstrated that HK-MoCA differentiated SVD patients from controls (AUC=0.81) with an optimal cutoff at 21/22.…”