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Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
The Montreal Cognitive Assessment (MoCA) is a widely used screening tool to detect cognitive impairment. It can be administered in an outpatient clinical setting, typically within 10–15 minutes. It is scored on a 30-point scale, with questions designed to test several cognitive domains, including orientation, short-term memory, delayed recall, attention, visuospatial abilities, executive function, language, and abstraction. A score of 25 points or lower is generally considered abnormal. For patients with fewer than 12 years of formal education, the cutoff shifts to 24 points. Regarding detection of mild cognitive impairment (MCI), the MoCA has a sensitivity of 89% and a specificity of 75%. For detection of dementia, it has a sensitivity of 91% and a specificity of 81%.5 The expected rates of score decline have not been clearly defined for either condition.
Description of mild cognitive impairment for stroke patients in the department of neurology at Jakarta Islamic Hospital, September–November 2015
Published in Ade Gafar Abdullah, Isma Widiaty, Cep Ubad Abdullah, Medical Technology and Environmental Health, 2020
This research study is a quantitative descriptive cross-sectional study to illustrate cognitive disorders in stroke patients. In this study, the technique used in data collection was primary data consisting of interviews and questionnaires. Data collection was conducted in September–December 2015, at the Neural Poly in the Central Jakarta Islamic Hospital. The respondents of this study were all post-stroke patients at the Jakarta Islamic Hospital in the September–November 2015 period. To assess cognitive function, the Indonesian version of Montreal Cognitive Assessment (MoCA-InA) was used, with a maximum value of 30. A final total score of 26 or more was considered normal. A total value of ≤25 indicates cognitive impairment (Friedman 2012).
The Difference of MMSE and MoCA-Ina Scores in Brain Tumors
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
S. Bangun, H. Sjahrir, F.I. Fitri
The MMSE is the most commonly used screening test for patients with brain tumor patients, despite limited validation in this setting. The Montreal Cognitive Assessment (MoCA) has superior sensitivity in part because it does not have a ceiling test effect, likely because it more extensively tests executive functioning, delayed recall, and abstraction (Olson, R.A., 2011; Nasreddine, Z.S., 2005).
Selection of cognitive impairment screening tools for longitudinal implementation in an HIV clinical care setting
Published in AIDS Care, 2023
Meghana L. Dantuluri, Leah H. Rubin, Yukari C. Manabe, Richard D. Moore, Keri N. Althoff
Neuropsychological test batteries are the gold standard for diagnosing cognitive impairment (Zgaljardic & Temple, 2010). These tests are heterogeneous in nature, but are the “gold standards” for measurements of the cognitive domains of attention, language, memory, spatial, and executive function (Zgaljardic & Temple, 2010). There are barriers to longitudinal use of these batteries in PLWH (Wilson et al., 2021). First, some of these batteries are time- and expertise-intensive and not usually feasible for use in the context of routine clinical care (Wilson et al., 2021). There are shortened and modified versions of these batteries used to screen for cognitive impairment, however, many of which are now available for administration using electronic devices. Second, both neuropsychological test batteries and screening tools must be calibrated for the younger and heterogeneous socioeconomic status of PLWH. For example, the Montreal Cognitive Assessment (MoCA) underestimated the burden of cognitive impairment in PLWH (Mwangala et al., 2018; Rosca et al., 2019). The Brain Baseline Assessment of Cognitive and Everyday Functioning (BRACE) has performance differences based on the patient’s education, drug use, and age (Rubin et al., 2021).
Cognitive-motor dual-task gait training within 3 years after stroke: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Prudence Plummer, Lisa A. Zukowski, Jody A. Feld, Bijan Najafi
This was a parallel-group, randomized, controlled trial with concealed allocation with 1:1 ratio and blinded outcome assessments conducted at baseline, completion of the intervention, and 6 months following completion of the intervention. Randomization sequence was computer-generated by the biostatistician. The study protocol was previously published in detail (Plummer-D’Amato et al., 2012b). There were five deviations from the original protocol, two of which were strategies to facilitate recruitment: 1) the post-stroke duration for eligibility was increased from 12 months to 3 years; and 2) the minimum score for inclusion on the Montreal Cognitive Assessment (MoCA) was reduced from 23 to 20. This resulted in the inclusion of two participants with MoCA scores of 22. All other participants had scores at least 23, as originally proposed. Since the sensitivity and specificity of the MoCA is optimized at a cut off of 23 (Luis, Keegan, and Mullan, 2009), the sample overall had mild, if any, cognitive impairment. Only 11 of the total 36 participants included in the analysis had post-stroke duration greater than the originally proposed 12 months.
Feasibility and acceptability of the multicontext approach for individuals with acquired brain injury in acute inpatient rehabilitation: A single case series
Published in Neuropsychological Rehabilitation, 2022
Abhishek Jaywant, Chelsea Steinberg, Alyson Lee, Joan Toglia
Screening assessments. The Montreal Cognitive Assessment (MoCA) (Nasreddine et al., 2005) is a 30-point performance-based cognitive screening instrument that is a standard of care measure on our IRU. It assesses the domains of visuospatial/executive function, attention, language, abstraction, memory, and orientation. A higher score indicates better cognitive performance. The standard cutoff for cognitive impairment is a score less than 26/30. The Trail Making Test (TMT) and Symbol-Digit Modalities Test (SDMT) were used to screen for executive dysfunction. The TMT is a neuropsychological measure of visual attention and processing speed (TMT-A) as well as rapid attentional shifting and cognitive flexibility (TMT-B). The SDMT (Smith, 1991) is a timed assessment of divided attention, working memory, incidental learning, and psychomotor speed. As depicted in Table 1, all participants demonstrated impaired performance on at least one of the TMT-A, TMT-B, and SDMT.