Concurrent validity of the short version of Montreal Cognitive Assessment (MoCA) for patients with stroke

Yali Feng,Jiaqi Zhang,Bo Chen,Ying Yin,Yi Zhou

doi:10.1038/s41598-021-86615-2

Abstract

The aim of the present study was to examine the concurrent validity of 2 Chinese versions of the short version of the Montreal Cognitive Assessment (MoCA) in patients with stroke, i.e., MoCA 5-minute protocol and National Institute for Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) 5-minute Protocol. A total of 54 patients and 27 healthy controls were enrolled in this study. In this study, the Neurobehavioural Cognitive Status Examination (NCSE) was used as an external criterion of cognitive impairment. We found that the 5-min protocol did not differ from the MoCA in differentiating patients with cognitive impairments from those without (area under the receiver operating characteristic curve, AUC, of 0.948 for the MoCA 5-min protocol v.s. 0.984 for MoCA, P = 0.097). These three assessments demonstrated equal performance in differentiating patients with stroke from controls. The Chinese version of the MoCA 5-min protocol can be used as a valid screening for patients with stroke.

Highlights

The Montreal Cognitive Assessment (MoCA) was developed by Nasreddine et al in 1996, and was initially used and validated to detect mild cognitive impairment (MCI) and mild forms of Alzheimer’s disease[1]
The objective of this study is to investigate the concurrent validity of these two short versions of MoCA, with reference to the Neurobehavioral Cognitive Status Examination (NCSE), which is one of the most widely used assessments for general cognition by neurological occupational therapists in C hina[15]
The participants who met any of the following criteria were excluded: (1) patients with severe aphasia, swallowing disorders or other complications post-stroke that prevent them from successfully completing the assessments; (2) patients with any previously known psychiatric disorder or neurological disease excluding stroke; (3) patients who have been assessed by the MoCA or NCSE within the past 3 months and (4) those who refuse to participate in this study

Summary

Introduction

The Montreal Cognitive Assessment (MoCA) was developed by Nasreddine et al in 1996, and was initially used and validated to detect mild cognitive impairment (MCI) and mild forms of Alzheimer’s disease[1]. In 2006, the National Institute for Neurological Disorders and Stroke-Canadian Stroke Networkproposed a 5-minute protocol that can be adopted as a possible cognitive screening tool for patients with stroke, by extracting three items (i.e., orientation, memory and verbal fluency) from the MoCA This assessment protocol is aimed to meet the requirement of busy clinics and to allow for administration over the telephone, which is very promising and helpful for poststroke cognitive s creening[5]. A second short version of MoCA was developed by Wong et al.[7], which was later named as the MoCA 5-min p rotocol[4] This protocol uses the same criteria (i.e., orientation, delayed recall and verbal fluency) from the full MoCA like the NINDS-CSN 5 min protocol, but with minor modifications in the assessment instruction and the grading system. We hypothesized that the MoCA 5-min protocol performs to full MoCA, and is more effective than the NINDS-CSN 5 min protocol in differentiating cognitively impaired from cognitively intact stroke patients as well as in differentiating patients with stroke from their age and education-matched healthy counterparts

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Results

Conclusion