Evidence of the Sensitivity of the MoCA Alternate Forms in Monitoring Cognitive Change in Early Alzheimer's Disease

Abstract

Background/Aims: There is an increasing interest in using the Montreal Cognitive Assessment (MoCA) test as a monitoring tool in Alzheimer's disease (AD) in both research and clinical settings. Our aim was to investigate the utility of alternate forms of the MoCA in detecting cognitive deterioration in a sample of early AD patients followed longitudinally in an outpatient memory clinic. Method: Twenty-five patients with early-stage AD (prodromal or mild dementia) were administered the original version and one of two previously validated alternate forms of the MoCA within an interval of about 1 year. The decline over time and the rate of change of the MoCA were compared to the total score of a standardized neuropsychological assessment battery (Consortium to Establish a Registry of Alzheimer's Disease; CERAD-Plus). Responsiveness to change was determined by calculating standard response means and the respective effect sizes. Results: Sixty percent of the sample showed a clinical decline on the clinical dementia rating (CDR) scale. There was significant deterioration in the MoCA and CERAD total scores. Conclusion: The results demonstrate that the MoCA is capable of detecting change over time and seems to be a valid tool with small to moderate sensitivity for monitoring cognitive change in early AD.