Vascular Cognitive Impairment: Most Useful Subtests of the Montreal Cognitive Assessment in Minor Stroke and Transient Ischemic Attack

Bocti, Christian; Legault, Véronique; Leblanc, Nancy; Berger, Léo; Nasreddine, Ziad; Beaulieu‐Boire, Isabelle; Yaneva, Krasimira; Boulanger, Jean-Martin

doi:10.1159/000351674

Cited by 42 publications

(42 citation statements)

References 48 publications

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“…The current levels of sensitivity and specificity are greater than those initially reported by Bocti et al [11] (91% and 83%, respectively) when investigating the performance of the miniMoCA in acute stroke patients. The major advantages of the MoCA over other CI screening tools in stroke populations (i.e.…”

Section: Discussioncontrasting

confidence: 70%

“…Cognitive function was also assessed using a shortened version of the complete MoCA [11]. A total score out of 10 was calculated based on patients' performance on five MoCA subtest items (verbal fluency, cube copy, trail making, five-word recall and abstraction).…”

Section: Mocamentioning

confidence: 99%

“…A total score out of 10 was calculated based on patients' performance on five MoCA subtest items (verbal fluency, cube copy, trail making, five-word recall and abstraction). A cut-off score for detecting CI was set at57/10 [11].…”

Section: Mocamentioning

confidence: 99%

“…To decrease the administration time and increase the utility of the MoCA in clinical settings, Bocti et al [11] provided empirical validation for a shortened version of the MoCA (miniMoCA), with adequate prediction of abnormal MoCA scores (526) in acute stroke patients.…”

Section: Introductionmentioning

confidence: 99%

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Screening and facilitating further assessment for cognitive impairment after stroke: application of a shortened Montreal Cognitive Assessment (miniMoCA)

Campbell

Rice

Friedman

et al. 2015

Disability and Rehabilitation

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Purpose: The purpose of this study is to examine the performance of a shortened version of the MoCA (miniMoCA), as a clinical cognitive impairment screening tool in stroke rehabilitation patients. Methods: Cognitive status was assessed using the MoCA and Cognistat in 72 patients. Agreement between the tests was assessed using the Kappa statistic. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of a miniMoCA to a MoCA score 526 was also examined. Results: A significant level of agreement was found between the MoCA and miniMoCA to the Cognistat in classifying patients by level of cognitive function. The miniMoCA showed a sensitivity of 93% and specificity of 92% (PPV 98%, NPV 75%) to abnormal MoCA scores (526). Conclusions: This study extends the utility of the miniMoCA as an optimal brief screening tool for cognitive impairment in stroke patients. Further research is needed to determine the validity of the miniMoCA against a neuropsychological test.ä Implications for RehabilitationAlthough the Montreal Cognitive Assessment (MoCA) is a recommended tool to screen for cognitive impairment in stroke patients, its lengthy administration can lead to inconsistent screening of patients for post-stroke cognitive function. In the current work, a shortened version of the MoCA (miniMoCA) was administered in a sample of stoke inpatients, utilizing only five of the eight original subtests. The proposed miniMoCA was found to streamline the administration of this screen test, while maintaining a heightened level of sensitivity for accurately identifying which patients do not require a more in-depth cognitive assessment.

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Section: Discussioncontrasting

confidence: 70%

Section: Mocamentioning

confidence: 99%

Section: Mocamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Screening and facilitating further assessment for cognitive impairment after stroke: application of a shortened Montreal Cognitive Assessment (miniMoCA)

Campbell

Rice

Friedman

et al. 2015

Disability and Rehabilitation

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“…Global cognitive function was also measured in some studies using the MMSE or MoCA. When assessing global cognitive function, the MoCA may be more useful than the MMSE for detecting cognitive impairment particularly in early stages of VCI [42]. Previous research has suggested that fluid abilities (e.g., information processing speed) may be more vulnerable to cerebrovascular dysfunction than crystallised abilities, at least at non-severe impairment stages [7,43].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Definitions of Vascular Cognitive Impairment, No Dementia in Cohort Studies

Harrison¹,

Tang²,

Keage³

et al. 2016

Dement Geriatr Cogn Disord

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Background/Aims: No set operational criteria for vascular cognitive impairment, no dementia (VCI-ND) have yet been established. The aim of this study is to undertake a systematic review to compare definitions of VCI-ND that have been used in cohort studies. Methods: Medline, PsycINFO and Embase were searched from inception to October 13, 2015. Initially, 3,142 records were screened, and 30 were included in this review. Results: No single set of criteria for defining VCI-ND was identified. VCI-NDwas broadly defined as an absence of dementia, cognitive impairment in at least one cognitive domain with signs of vascular involvement, and intact activities of daily living. Conclusion: Defining criteria will enable individuals with VCI-ND to be efficiently compared across cohort studies to more accurately determine the prevalence and risk of dementia.

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Accuracy of the short‐form Montreal Cognitive Assessment: Systematic review and validation

McDicken

Elliott

Blayney

et al. 2019

Int J Geriat Psychiatry

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Introduction Short‐form versions of the Montreal Cognitive Assessment (SF‐MoCA) are increasingly used to screen for dementia in research and practice. We sought to collate evidence on the accuracy of SF‐MoCAs and to externally validate these assessment tools. Methods We performed systematic literature searching across multidisciplinary electronic literature databases, collating information on the content and accuracy of all published SF‐MoCAs. We then validated all the SF‐MoCAs against clinical diagnosis using independent stroke (n = 787) and memory clinic (n = 410) data sets. Results We identified 13 different SF‐MoCAs (21 studies, n = 6477 participants) with differing test content and properties. There was a pattern of high sensitivity across the range of SF‐MoCA tests. In the published literature, for detection of post stroke cognitive impairment, median sensitivity across included studies: 0.88 (range: 0.70‐1.00); specificity: 0.70 (0.39‐0.92). In our independent validation using stroke data, median sensitivity: 0.99 (0.80‐1.00); specificity: 0.40 (0.14‐0.87). To detect dementia in older adults, median sensitivity: 0.88 (0.62‐0.98); median specificity: 0.87 (0.07‐0.98) in the literature and median sensitivity: 0.96 (range: 0.72‐1.00); median specificity: 0.36 (0.14‐0.86) in our validation. Horton's SF‐MoCA (delayed recall, serial subtraction, and orientation) had the most favorable properties in stroke (sensitivity: 0.90, specificity: 0.87, positive predictive value [PPV]: 0.55, and negative predictive value [NPV]: 0.93), whereas Cecato's “MoCA reduced” (clock draw, animal naming, delayed recall, and orientation) performed better in the memory clinic (sensitivity: 0.72, specificity: 0.86, PPV: 0.55, and NPV: 0.93). Conclusions There are many published SF‐MoCAs. Clinicians and researchers using a SF‐MoCA should be explicit about the content. For all SF‐MoCA, sensitivity is high and similar to the full scale suggesting potential utility as an initial cognitive screening tool. However, choice of SF‐MoCA should be informed by the clinical population to be studied.

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Vascular Cognitive Impairment: Most Useful Subtests of the Montreal Cognitive Assessment in Minor Stroke and Transient Ischemic Attack

Cited by 42 publications

References 48 publications

Screening and facilitating further assessment for cognitive impairment after stroke: application of a shortened Montreal Cognitive Assessment (miniMoCA)

Screening and facilitating further assessment for cognitive impairment after stroke: application of a shortened Montreal Cognitive Assessment (miniMoCA)

A Systematic Review of the Definitions of Vascular Cognitive Impairment, No Dementia in Cohort Studies

Accuracy of the short‐form Montreal Cognitive Assessment: Systematic review and validation

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