Version Of Montreal Cognitive Assessment Research Articles

Correlation among personal, social performance and cognitive impairment in male schizophrenic patient

Schizophrenia is a dramatic mental illness with tragic manifestation. The consequences of the illness are for the individual, affected his or her family and society. Schizophrenia is one of the twenty illness that causes Years Lost due to Disability. Treating only the symptom is insufficient. The aim of treatment must include the quality of life of aschizophrenic person. This study aims to examine the relationship between cognitive impairment and performance of the person with schizophrenia. Cognitive test is scaled with Indonesian version of Montreal Cognitive Assessment (MoCA-Ina), while personal and social performance isscaled with Personal and Social Performance scale. There are many studies that search the relationship between cognitive impairment and social functioning of schizophrenic patients, but this is the first study that uses PSP and MoCA-Ina. Both PSP and MoCA-Ina are easy to use but still have high sensitivity and specificity, and perhaps can build people’s interest to use it in clinical practice. Twenty-five male schizophrenic patients were assessed in Prof. M. Ildrem Mental Hospital of North Sumatera Province of Indonesia. Positive correlations between MoCA-Ina and PSP score were identified. Clinicians should pay attention to cognitive and might give some early intervention to it.

Patients with chronic insomnia disorder have increased serum levels of neurofilaments, neuron-specific enolase and S100B: does organic brain damage exist?

ObjectivesThe aims of this study were to investigate whether serum levels of neurofilaments heavy chain (NfH) and light chain (NfL), neuron-specific enolase (NSE) and S100 calcium binding protein B (S100B): (1) change, (2) alleviate in post-therapy and (3) are associated with sleep quality and cognitive dysfunction, in patients with chronic insomnia disorder (CID). MethodsForty CID outpatients constituted free-therapy group (ft-CID), in which twenty-four patients completed follow-up after six-month treatment to form re-visiting group (rv-CID), and twenty healthy good sleepers constituted control group (HC). All subjects completed questionnaires, polysomnography, Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test (NBMT) to assess sleep and neuropsychological function. The serum levels of NfH, NfL, NSE and S100B were detected using enzyme-linked immunosorbent assay. ResultsThe ft-CID had higher levels of NfH, NfL, NSE and S100B than the HC. Of note, the levels of NfH, NfL and NSE were significantly reduced in the rv-CID compared to the ft-CID, but not the level of S100B. Principal components analysis revealed that in these serum biomarkers, NfL and S100B had a substantial correlation with subjective and objective sleep parameters. ConclusionsThe CID patients had elevated serum levels of NfH, NfL, NSE and S100B, indicating existence of damaged brain microstructure, including neurons, astrocytes and neuronal terminals, which were associated with the insomniac severity or/and cognitive dysfunction and could significantly reduce after effective therapy apart from the S100B.

Memory Performance in Patient with Systemic Lupus Erythematosus Using MoCA-Ina in Hasan Sadikin Genneral Hospital Bandung

Background: The involvement of neuropsychiatry is reported in 6% to 91% of Systemic Lupus Erythematosus (SLE) patients. It can cause fatal morbidity and mortality. Memory impairment is one of the most common symptoms of neuropsychiatry involvement. This study aims to find out the performance of memory test in SLE patients using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina).Method: This cross sectional study recruited 30 SLE patients. Cognitive abilities and patient’s memory were examined using Indonesian version of Montreal Cognitive Assessment (MoCA-Ina). Cognitive impairment was determined when total MoCA-Ina score was below 26. For memory evaluation, immediate recall or delayed recall impairment was determined when the patient failed in each memory subtests.Results: The mean of total MoCA-Ina score was 24.97 (SD±3.14). Fifty percent of the SLE patients had cognitive impairment, with the domain involved being delayed recall (86.67%), attention (60%), language (56.67%), abstraction (53.33%), and visuo-spatial/ executive function (36.67%). Most patients (86.67%) could completely repeat immediate recall. Whileonly 4 (13.33%) subjects could repeat delayed recall completely without any clue. Of the 26 SLE patients who failed to recall completely, 24 (92.3%) of them succeeded to recall completely after getting clue(s).Conclusion: Memory impairment is the most frequent cognitive impairment in SLE patients, especially in delayed recall. By using the memory subtests of MoCAIna, more than four fifth of patients with SLE was detected having delayed recall memory impairment and almost all of them could recalled completely after getting clue(s). This findings indicated that the finalstep of memory process retrieval in SLE was interrupted while being encoded, but retention pathway were stillintact.Keywords: Systemic Lupus Erythematous, Memory, MoCA-Ina

A Multicenter, Randomized, Double-blind, Placebo-controlled Clinical Trial for Efficacy of Acetyl-L-carnitine in Patients with Dementia Associated with Cerebrovascular Disease.

Background and PurposeAcetyl-L-carnitine (ALC) is a widely used drug for various neurodegenerative diseases including dementia. The aim of the present study was to elucidate the efficacy of ALC in dementia patients with cerebrovascular disease (vascular cognitive impairment; VCI).MethodsFifty-six patients were randomized to treatment with 500 mg ter in die ALC, or placebo in this 28-week, double-blind, placebo-controlled trial. The primary outcome measure was the Korean version of Montreal Cognitive Assessment (MoCA-K).ResultsFollowing treatment with ALC, the cognitive function measured by the MoCA-K was significantly improved in the ALC-treated groups. However, other secondary outcomes were not statistically significant between ALC- and placebo-treated groups. In MoCA-K analysis, attention and language sub-items significantly favored the ALC-treated group.ConclusionsCompared with placebo, treatment with ALC 1,500 mg/day produced significant changes in MoCA-K in dementia patients with VCI. ALC was well tolerated in this population. Despite the study limitations, the findings suggested the potential benefits associated with the use of ALC in dementia patients with VCI.

Effects of an Exercise Protocol for Improving Handgrip Strength and Walking Speed on Cognitive Function in Patients with Chronic Stroke.

BackgroundHandgrip strength and walking speed predict and influence cognitive function. We aimed to investigate an exercise protocol for improving handgrip strength and walking speed, applied to patients with chronic stroke who had cognitive function disorder.Material/MethodsTwenty-nine patients with cognitive function disorder participated in this study, and were randomly divided into one of two groups: exercise group (n=14) and control group (n=15). Both groups underwent conventional physical therapy for 60 minutes per day. Additionally, the exercise group followed an exercise protocol for handgrip using the hand exerciser, power web exerciser, Digi-Flex (15 minutes); and treadmill-based weight loading training on their less-affected leg (15 minutes) using a sandbag for 30 minutes, three times per day, for six weeks. Outcomes, including cognitive function and gait ability, were measured before and after the training.ResultsThe Korean version of Montreal Cognitive Assessment (K-MoCA), Stroop test (both simple and interference), Trail Making-B, Timed Up and Go, and 10-Meter Walk tests (p<0.05) yielded improved results for the exercise group compared with the control group. Importantly, the K-MoCA, Timed Up and Go, and 10-Meter Walk test results were significantly different between the two groups (p<0.05).ConclusionsThe exercise protocol for improving handgrip strength and walking speed had positive effects on cognitive function in patients with chronic stroke.

The feasibility study of Computer Cognitive Senior Assessment System-Screen (CoSAS-S) in critically ill patients with sepsis

PurposeEarly cognitive assessment in the intensive care unit (ICU) is essential to monitor cognitive dysfunction after critical illness. We have implemented a Computer Cognitive Senior Assessment System–Screen (CoSAS–S) which is a brief, objective, and tablet-based cognitive screening test as a mobile platform to detect any cognitive problems in ICUs. This study aimed to evaluate the feasibility and initial validation of a tablet-based CoSAS–S in critically ill patients with sepsis. Materials and methodsThirty-six eligible patients completed CoSAS–S, Mini-Mental State Examination–Korean Version (MMSE–K) and Korean Version of Montreal Cognitive Assessment (K-MoCA) for validity testing at the ICU. ResultsEighty-eight percent of programmed assessments were completed by the sample. Spearman correlations of the CoSAS–S with MMSE–K (rho=0.613–0.874, p<0.00) and K–MoCA scores (rho=0.666–0.897, p<0.001) were moderate to high. Intra-class correlation coefficient (ICC) of total CoSAS–S score between two raters was 0.93 (p<0.001; 95% CI=0.82–0.97), suggesting the inter-rater reliability of CoSAS-S was excellent. ConclusionsSupport was found for the feasibility and validity of CoSAS-S. The application of CoSAS-S could identify the cognitive functioning of the patients. Utility of CoSAS-S in other clinical populations should be tested.

Odor selectivity of hyposmia and cognitive impairment in patients with Parkinson's disease.

ObjectiveHyposmia is one of the earliest non-motor features of Parkinson’s disease (PD) and can precede the onset of motor symptoms by years. Most of the current olfactory detection tests are targeted at Western populations. The exact relationship between hyposmia and cognitive impairment is unknown. The purpose of the study was to find bromines that can effectively identify olfactory dysfunction and investigate the relationship between hyposmia and cognitive function in early, non-demented, drug-naïve patients with PD in the People’s Republic of China.MethodsSixty-three early, non-demented, drug-naïve patients with PD and 55 healthy controls were enrolled in the study. The T&T olfactometer and a Chinese version of Montreal Cognitive Assessment (MoCA) were applied to assess subjects’ olfactory and cognitive functions. Patients with PD also completed the Modified Unified Parkinson’s disease-rating scale (UPDRS) and Hoehn and Yahr (H&Y) scale.ResultsPatients with PD had lower scores of visuospatial and executive function (p=0.000), attention (p=0.03), and delayed recall (p=0.001) than controls. β-phenylethyl alcohol (floral smell, smell of rose petals) and isovaleric acid (smell of sweat, stuffy socks) were more sensitive for identifying hyposmia in patients with PD than three other odors. Multivariate logistic regression analysis showed that impaired visuospatial and executive function was associated with hyposmia (p=0.013), but was independent of other PD-associated variables.ConclusionHyposmia was common in early, non-demented, drug-naïve PD patients. β-Phenylethyl alcohol and isovaleric acid were more superior for identifying hyposmia in early non-demented Chinese patients with PD. Hyposmia was associated with impaired visuospatial and executive function in patients with PD. Further prospective studies that apply a series of neuropsychological tests and functional magnetic resonance imaging methods in large samples in multicenter studies are needed to confirm our findings and to investigate the relationship between hyposmia and cognitive function with disease progression in patients with PD.

PP.16.11] RELATIONSHIP BETWEEN BLOOD PRESSURE VARIABILITY AND COGNITIVE FUNCTION IN ELDERLY PATIENTS WITH STRICT BLOOD PRESSURE CONTROL

Objective: Although higher blood pressure (BP) level and BP variability has been associated with decline cognitive function, data are sparse regarding to the relationship between BP variability and cognitive function in elderly patients with strict BP control. The aim of this study is to test the hypothesis whether BP variability using ABPM would be associated with cognitive function assessed by MoCA in the population who has already achieved strict home BP control from DCAP Netwrok. Design and method: We analyzed 232 patients from the Disaster CArdiovascular Prevention (DCAP) network, which developed a web-based home BP monitoring to achieve BP control for the support in disaster area after East Japan Earthquake. All patients were performed ambulatory BP monitoring and the Japanese version of Montreal Cognitive Assessment (MoCA-J). Results: The mean age was 77.7 years, 33.6% were male, and 85.3% were administrated anti-hypertensive drug. Average 24-hour BP level was 118.7 ± 10.0/68.3 ± 6.4 mmHg. When we divided weighted standard deviation of systolic BP (SBP) as measure of BP variability into quartiles, the top quartile group was significantly lower total MoCA-J score (15.4 [95% confidence interval 14.2–16.7] vs. 17.9 [17.2–18.6]) and its domains, visuoexecutive (2.2 [1.9–2.6] vs. 2.8 [2.6–2.9]), abstraction (1.0 [0.7–1.2] vs. 1.3 [1.1–1.4]), attention (2.8 [2.4–3.1] vs. 3.6 [3.4–3.8]), and naming (2.1 [1.9–2.3] vs. 2.5 [2.4–2.6]) than the group of other quartiles after adjusted by age and 24-hr SBP. These associations were not found in the quartiles of 24-hour SBP. Conclusions: In elderly patients with strict ambulatory BP control, higher BP variability, not average ambulatory BP level, was associated with cognitive decline.

DEVELOPMENT AND VALIDATION OF THE HONG KONG MONTREAL COGNITIVE ASSESSMENT (HK-MOCA) ALTERNATE VERSIONS FOR SCREENING OF MILD COGNITIVE IMPAIRMENT

The Montreal Cognitive Assessment (MoCA) is a valid and widely used cognitive test in clinical and research settings. However, repeated testing in same individuals results in practice effect which may mask true cognitive changes when evaluating treatment efficacy. The objective of this study is to develop two alternate versions of the Hong Kong version of MoCA (HK-MoCA), together with two alternate versions of the 5-minute protocol and to investigate the validity and reliability of the alternate versions in elderly persons with normal cognition and mild cognitive impairment (MCI) patients. The availability of alternate versions of the HK-MoCA will significantly improve the accuracy in measuring cognitive changes in clinical and research settings. Thirty normal controls and 30 patients with MCI were tested with each alternate version (namely V1-HK-MoCA and V2-HK-MoCA) and the original version one month apart of each other. Twenty subjects were further administered the same alternate version one month later to assess test-retest reliability. Correlational and Bland-Altman analyses for the original and alternate versions of HK-MoCA were performed. Criterion validity was assessed by ability to differentiate MCI from controls using receiver operation curve (ROC) analysis. One-month test-retest reliability was indexed by the intra-class correlation coefficient. The original HK-MoCA and the two alternate versions were highly correlated (V1-HK-MoCA, Pearson r=.87, p<.001; V2-MoCA, Pearson r=.79, p<.001). The alternate versions both showed excellent test-retest reliability (V1-MoCA, Intra-class r=.92, p<.001; V2-MoCA, Intra-class r=.82, p<.001), together with good internal consistency (V1-MoCA: α=.79; V2-MoCA: α=.75). The alternate versions also showed excellent to good ability to detect MCI from normal (ROC area under curve: V1-MoCA=0.92; V2-MoCA=0.72). Bland-Altman analysis of the alternate versions showed a high level of agreement with the original HK-MoCA with no proportional bias.

P029 Effects of dual-mode non-invasive brain stimulation on freezing of gait in patients with Parkinson’s disease

Purpose Our previous study demonstrated the favorable effect of repetitive transcranial magnetic stimulation (rTMS) over both the dominant primary motor cortex of lower leg (M1-LL) and the left dorsolateral prefrontal cortex (DLPFC). The aim of this study was to investigate the effects of dual-mode non-invasive brain stimulation (NBS) on FOG using both rTMS and tDCS in patients with PD. Methods This study was a randomized controlled double-blind study comparing the effect of single vs. dual-mode stimulation. Thirty-two patients with PD that featured FOG were included and divided into two groups. For the dual-mode stimulation, 10 Hz rTMS over the dominant M1-LL and the anodal tDCS over the left DLPFC were simultaneously applied for 20 min per session, 5 sessions in a week. For the single stimulation, rTMS were applied at the same manner. Behavioral, neurophysiologic and cognitive outcomes were measured before, after, and 1 week after the intervention by the Timed Up and Go (TUG) test, Standing Start 180° Turn (SS-180° Turn Step/Time) test, Unified Parkinson’s Disease Rating Scale (UPDRS) part III, FOG Questionnaire (FOG-Q), motor evoked potential, Korean version of Montreal Cognitive Assessment (K-MOCA), Digit span-Forward/Back and Trail Making-A/B. Results There were significant improvements in TUG, SS-180° Turn Step, UPDRS part III and FOG-Q in both the dual-mode and the single stimulation group (p 0.05). The dual-mode stimulation also resulted in significant improvements in SS-180° Turn Time (p = 0.008), K-MOCA (p = 0.004), Digit span-Forward (p = 0.015) and Trail making-B test (p = 0.010), whereas single stimulation did not. Furthermore, improvement of Trail making-B test was significantly greater after the dual-mode stimulation than the single stimulation (p = 0.024). Conclusion The dual-mode stimulation using the 10 Hz rTMS over the dominant M1-LL and the anodal tDCS over the left DLPFC was more effective than single stimulation for improving FOG in combination with cognitive improvement in patients with PD.

Body Mass Index Is Related to Cognitive Function in Chinese Older Adults: So What?

The relation between Body Mass Index (BMI) and cognitive function in the elderly was found conflictory in studies of western samples and under-explored in mainland China. This study explored the relation with a sample of 447 older adults from Wuhan, central China. Cognitive function was measured with the Chinese version of Montreal Cognitive Assessment (MoCA). A mixture modeling revealed that BMI was negatively related to cognitive function only in a small proportion of the sample, who averaged highest in age but lowest in education and BMI. Practical implication of this finding was discussed.

Lifestyle, Physical Activity and Cognitive Functions: the impact on the scores of Montreal Cognitive Assessment (MoCa).

The Montreal Cognitive Assessment (MoCA) is a rapid screening tool, including subtests to assess several cognitive domains, developed to detect MCI from normal ageing cognitive changes. Several validation and normative studies have conducted around the world considering the influences of age and education on the MoCA score, but none takes into account the lifestyle and habits. However, lifestyles, and particularly physical activity (PA) have been positively associated with both physical and mental health in elderly. The aim of the present study is to investigate the influence of regularly practiced PA on the MoCA scores in a sample of Italian healthy elderly males. For this purpose sixty-five healthy adult males, aged 65-81 years were assigned to two groups, physically active group (PAG, N=33), and sedentary group (SG, N=32), according to recommended levels of physical activity by the World Health Organization. The Italian version of MoCA was administered to each participant. Raw data were analysed by a multiple regression model in which the independent variables were PA, age and education. Results showed a highly significant influence of PA on MoCA total score and on several cognitive domain sub-scores. Furthermore, multiple regression analysis indicated a larger impact on scores by PA than both age and education. In the light of these findings, it is advisable to pay attention to the life style of subject that undergoing a neuropsychological evaluation like the MoCa and in particular the level of PA practiced, as well as age and education.

Validity of the Georgian Montreal Cognitive Assessment for the Screening of Mild Cognitive Impairment and Dementia.

Montreal Cognitive Assessment (MoCA) test has been shown to be a reliable tool to detect mild cognitive impairment (MCI), however, no Georgian language version exists. The goal of this study is to determine the validity, reliability, and accuracy of Georgian version of MoCA in the evaluation of amnestic MCI (aMCI) and Alzheimer's disease (AD). Montreal Cognitive Assessment was translated into Georgian language and was administered to healthy participants (HP) and patients with aMCI and AD. We studied 46 HS, 20 patients with aMCI, and 20 patients with AD. There was significant difference in MoCA scores between HP, patients with aMCI, and patients with AD ( P = 0.04). The area under the receiver operating characteristic curve for the aMCI and AD groups by MoCA was 0.88 and 0.95, respectively, compared to 0.43 and 0.67 by Mini-Mental State Examination (MMSE). The Georgian version of MoCA is a valid, reliable, and sensitive screening tool to detect aMCI and AD in Georgian-speaking population and is superior to MMSE.

The Montreal Cognitive Assessment (MoCA) as a screening test for cognitive dysfunction in multiple sclerosis

ABSTRACTThis study investigates the utility of the Portuguese version of Montreal Cognitive Assessment (MoCA) as a screening-method for identifying cognitive dysfunction (CD) in multiple sclerosis (MS). The 118 participants with comprehensive neuropsychological assessment were divided into two subgroups: (I) MS group (n = 59) and (II) control group (n = 59). The MS patients were classified as cognitively intact (n = 26) or impaired (n = 33, 56%). The results indicated that the MoCA is a psychometrically valid instrument in assessment of MS patients. The Multiple Linear Regression analyses highlighted the significant influence of Modified Fatigue Impact Scale and Irregular Word Reading Test on MoCA performance. The MoCA total score showed a good discriminative capacity between cognitively impaired and cognitively intact subjects. In addition, there were significant differences in MoCA cognitive domain scores between groups. The MoCA total score cut-off point for identifying CD in MS patients was a score below 26 points (AUC = 0.837, CI = 0.736–0.937). A proposed EM-MoCA-Subscore for identifying the MS-related cognitive impairment (max. score = 19 points, cut-off <17 points, AUC = 0.871, CI = 0.784–0.958), can reduce administration time for cognitive screening in clinical settings. The MoCA is a useful and sensitive instrument to identify the MS-related cognitive impairment.

Validation of Montreal Cognitive Assessment, MoCA, Alternate French Versions.

Objective background: The Montreal Cognitive Assessment (MoCA) is a questionnaire that has been developed to help physicians around the world diagnose a patient's cognitive ability. Available in multiple languages and for use in multiple countries worldwide, the goal of this study was to validate the alternate versions 2 and 3 of the French MoCA test to assist physicians in the detection of mild cognitive impairment (MCI), while decreasing the learning effect upon frequent testing. A validation study was conducted at the MoCA Clinic and Institute in Québec, Canada. The subject population consisted of 25 patients diagnosed with MCI meeting Petersen criteria and 25 healthy subjects serving as the normal control (NC) group. Three MoCA test versions were administered in the French language in random order within one session. Scores obtained in all three versions in MCI and NC groups were assessed for reliability and consistency from one version to the next. On average, scores obtained in each subject group (MCI and NC) fell within their corresponding diagnostic ranges (score above 26 points for NC patients versus scores below 26 points for MCI patients). Difference in scores observed between the original French MoCA version and the two alternate versions in each subject cohort were minimal and not considered clinically significant. All three test versions of the French MoCA are considered equivalent in diagnostic reliability and consistency and contribute to decreasing the potential learning effect when patients are required to repeat the test frequently.

BEIJING VERSION OF THE MONTREAL COGNITIVE ASSESSMENT FOR ELDERLY CHINESE AMERICANS

The Beijing version of Montreal Cognitive Assessment (B-MoCA) was originally developed for Mandarin speakers but can also be used for Cantonese speakers. Our study aimed to evaluate the capability of B-MoCA in identifying elderly U.S. Chinese participants with Mild Cognitive Impairment (MCI) or dementia. We administered the B-MoCA test to 86 elderly Chinese Americans during a standard dementia evaluation as part of a clinical study at the Mount Sinai Alzheimer’s Disease Research Center (MSADRC). All participants were primarily Chinese speaking and ≥ 65 years old. Clinical diagnoses of Normal Control (NC), MCI, and dementia were made by clinicians, who were blinded to the B-MoCA scores, using criterion sheets developed at the MSADRC. The effects of diagnostic categories (NC, MCI, and dementia) and education levels (I: 0-8 years, II: 9-12 years, and III: 13-20 years) on the total B-MoCA scores were investigated by analysis of covariance (ANCOVA); age was treated as a covariate. The sensitivity and specificity of B-MoCA were assessed for detection of MCI or dementia. Our study recruited 52 Mandarin-speaking and 34 Cantonese-speaking participants, with average age of 73.70±6.16 years old and education of 12.92±4.65 years. 48 participants were diagnosed as NC, 27 with MCI, and 11 with dementia. The mean ages were comparable between three groups. Participants in the NC group tended to have higher education than participants in other two diagnostic groups. The B-MoCA scores for the NC, MCI, and dementia groups were 24.58±3.221, 20.04±3.579, and 15.11±5.840, respectively. The average age for participants in level I education group was older than the other two levels (II and III), and the mean B-MoCA score of participants in level I education group was 3.21 and 5.45 lower than those in level II and II groups, respectively. The ANCOVA showed that education and diagnostic categories had a major impact on the B-MoCA scores, even after adjusted for age. With a cut-off score of 26, the B-MoCA can detect MCI or dementia with a sensitivity of 47.9%, and a specificity of 97.2%. The B-MoCA is a useful neuropsychological tool for identifying elderly Chinese Americans with MCI or dementia.

Wide range of body composition measures are associated with cognitive function in community-dwelling older adults.

Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults. A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass. The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P < 0.05), except for the Rey Auditory Verbal Learning Test. Waist-to-hip ratio was detected as a significant predictor for all cognitive tests among women (P < 0.05), but was only a significant predictor for the Bahasa Malaysia version of Montreal Cognitive Assessment among men (P < 0.05). These results suggest that there is a need to maintain muscle mass and lower adipose tissue among older adults for optimal cognitive function. Geriatr Gerontol Int 2017; 17: 554-560.

A subtest analysis of the Montreal cognitive assessment (MoCA): which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease?

It is necessary to continue to explore the psychometric characteristics of key cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) to diagnose cognitive decline as early as possible and to attend to the growing need of clinical trials involving mild cognitive impairment (MCI) participants. The main aim of this study was to assess which MoCA subtests could best discriminate between healthy controls (HC), participants with MCI, and Alzheimer's disease (AD). Cross-sectional analysis of 136 elderly with more than four years of education. All participants were submitted to detailed clinical, laboratory, and neuroimaging evaluation. The MoCA, Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), Geriatric Depression Scale (GDS), and Functional Activities Questionnaire (FAQ) were applied to all participants. The MoCA test was not used in the diagnostic procedure. Median MoCA total scores were 27, 23 and 18 for HC, MCI, and AD, respectively (p < 0.001). Word repetition, inverse digits, serial 7, phrases, verbal fluency, abstraction, and word recall discriminated between MCI and HC participants (p < 0.001). The clock drawing, the rhino naming, delayed recall of five words and orientation discriminated between patients with MCI and AD (p < 0.001). A reduced version of the MoCA with only these items did not improve accuracy between MCI and HC (p = 0.076) or MCI and AD (p = 0.119). Not all MoCA subtests might be fundamental to clinical diagnosis of MCI. The reduced versions of MoCA did not add diagnostic accuracy.

Italian Validation of Montreal Cognitive Assessment

Neuropsychological testing is a milestone of good practice to document cognitive deficits in a rapidly aging population. The aim of this paper is to validate the Italian version of Montreal Cognitive Assessment (MoCA). We compared subjects performance at the Italian version of MoCA with performance at standard Mini Mental State Examination (MMSE). The whole sample is composed of 287 subjects. All participants were administered three MoCA and a standard MMSE within 4 weeks. Through ROC analysis the optimal MoCA cut-off point was identified, showing high levels of sensitivity and specificity and an accuracy of .96, with 95% confidence interval. Intra rater reliability and intra rater reliability are highly significant with respect to the MMSE. Results highlight that MoCA is a valid instrument in clinical and research screening and monitoring of subjects affected by cognitive disorders. Further studies may be directed to the deepening of the reliability and validity of the test.

Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P < 0.001; healthy controls: R = 0.26; P = 0.04) and Addenbrooke's Cognitive Examination (patients: R = 0.8; P < 0.001; healthy controls: R = 0.52; P < 0.001) scores. This study establishes the reliability of cross-cultural adaptation of Montreal Cognitive Assessment for assessing cognition in Malayalam-speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.