Abstract
Background: Diagnostic investigation of dementia is based on a series of tests which lie the neuropsychological evaluations. The Montreal Cognitive Assessment (MoCA) was developed as an instrument to recognize Mild Cognitive Impairment (MCI) and initial cases of Alzheimer’s disease. The present study aims to evaluate the predictive value of Brazilian MoCA test version in a sample of elderly above 5 years of education. Methods: Cross-sectional study with 136 elderly, above 60 years old at least 5 years of education. Diagnostic criteria is based on clinical and neuropsychological data classified Alzheimer’s disease n = 52, MCI n = 45 e normal controls n = 39. MoCA test was compared with Cambridge Cognitive Examination, Mini-Mental State Exam, Verbal Fluency, Clock Drawing Test, Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire. Accuracy was evaluated by receiver operating characteristic (ROC) curve analyses. Pearson correlation coefficient was used to compare the MoCA with the other tests. It was also used logistic regression analysis to identify the main risk factors for the diagnostic groups. Results: MoCA was the best test to differentiate Alzheimer’s disease cases from MCI with 86.5% sensitivity and 75.6% specificity. Furthermore, analyzes of correlation test showed that MoCA correlates robust way of already validated with other tests and wide application inBrazil. Conclusions: It can be concluded that MoCA is a good screening tool for investigation of MCI among the elderly in Brazil with over 5 years of schooling. Studies with larger numbers of participants are needed to further validate the test also for elderly people with low education.
Highlights
Aging is a process where significant losses occur in physical and cognitive abilities of the individual and those changes do not interfere with the functionality to perform their activities [1,2]
Analyzes were performed by means of receiver operating characteristic (ROC) curve and the results show that the highest value of AUC (Area Under the Curve) was founded in Montreal Cognitive Assessment (MoCA)
For differential diagnoses we suggest that, for people with over 5 years of schooling, subjective memory complaint coupled with evidence of cognitive decline in MoCA and the verbal fluency test animals version, in addition to activities of daily living impairment, separate cases of dementia (AD) from Mild Cognitive Impairment (MCI)
Summary
Aging is a process where significant losses occur in physical and cognitive abilities of the individual and those changes do not interfere with the functionality to perform their activities [1,2]. In spite of the forgetfulness for recent events are an early diagnostic sign for Alzheimer’s disease (AD) [3,4,5,6,7], declines in memory established by neuropsychological assessment (according to age and educational level) that does not interfere with basic activities (ADL) and instrumental (IADL’s) daily life give rise to a new construct, called Mild Cognitive Impairment (MCI) [8,9,10,11,12]. Diagnostic investigation of dementia is based on a series of tests which lie the neuropsychological evaluations. The present study aims to evaluate the predictive value of Brazilian MoCA test version in a sample of elderly above 5 years of education. Studies with larger numbers of participants are needed to further validate the test for elderly people with low education
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