Utility of the MoCA for cognitive impairment screening in long-term psychosis patients

Abstract

Cognitive impairment is a key feature in patients with psychotic disorders. The Montreal Cognitive Assessment (MoCA) is a brief tool that has been shown to be effective in identifying mild cognitive impairment and early dementia. This study explores the usefulness of this instrument to detect cognitive impairment in long-term psychotic disorders. One hundred-forty stabilized patients were re-evaluated more than 15 years after a First Episode of Psychosis (FEP). Patients were psychopathologically assessed, and the MoCA test and MATRICS Consensus Cognitive Battery (MCCB) were administered. Two cut-off scores for cognitive impairment using the MCCB were applied (T score <40 and <30). Concurrent validation was found between the total scores of the MoCA and MCCB. We also found significant associations between 5 out of 7 MoCA subtests (visuospatialexecutive, attention, language, abstraction and delayed recall) and MCCB subtests but not for the naming and orientation MoCA subtests. Receiver operating characteristic (ROC) analysis suggested a <25 cut-off for cognitive impairment instead of the original <26. Our results suggest that the MoCA test is a useful screening instrument for assessing cognitive impairment in psychotic patients and has some advantages over other available instruments, such as its ease-of-use and short administration time.

The relationship between cognitive functioning, age and employment in people with severe mental illnesses in an urban area in India: A longitudinal study

“…The MoCA total score had moderate levels of internal consistency at baseline and follow-up (Cronbach’s alphas = 0.63 and 0.57, respectively). These Cronbach’s alphas are similar to those reported in three other studies from India using the MoCA with elderly participants or people with Parkinson's disease (range: 0.64–0.72) ( Gupta et al, 2019 ; Krishnan et al, 2015 ; Thomas et al, 2018 ), and slightly lower than studies of the English version of the MoCA administered to persons with psychosis, Alzheimer's disease, or elderly participants (range: 0.76–0.83) ( Gil-Berrozpe et al, 2020 ; Nasreddine et al, 2005 ). The test-retest reliability of the MoCA total over the one-year follow-up was also high ( ICC = 0.85), with no significant change over time.…”

Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia

“…In addition, loss of synapses plasticity and impaired electrical conductivity can be observed, which causes elongation of the nerve impulse path and ultimately the death of neurons [29]. These factors attribute to the clinical phenotype of the disease, in which, apart from mental and behavioral problems, cognitive disorders occur, including distortions of thinking and perception, inability to adapt behavior to the situation, or dementia [30], which successively affect executive functions [31]. Depending on the time of diagnosis, early introduction of appropriate pharmacotherapy or psychotherapy of patients and their families guarantees complete recovery after the onset of the first psychotic episode, while its lack becomes the cause of FEP progression into a chronic and full-blown schizophrenia [32] with a worse treatment prediction [33] and is associated with a reduction in the chances of patient's full recovery [34,35].…”

A systematic review of research on neuropsychological measures in psychotic disorders from low and middle-income countries: The question of clinical utility

“…More studies in which the performance of brief tests is compared against comprehensive batteries like the MATRICS consensus cognitive battery (MCCB) are needed. To date most studies have compared the performance of comprehensive batteries like the CogState and the MOCA which have little utility in LMICs with MCCB ( Gil-Berrozpe et al, 2020 ; Lees et al, 2015 ). However, the results of these studies provide some support for validity.…”