Montreal Cognitive Assessment for the screening and prediction of cognitive decline in early Parkinson's disease |
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| Affiliation: | 1. Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, South Korea;2. Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea;3. Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea;4. Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea;5. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea;6. Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea;1. Department of Neurology, Athens Naval Hospital, Deinokratous, Athens 70, Greece;2. 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Greece;3. Statens Serum Institut, 5 Artillerivej, Copenhagen DK-2300, Denmark;4. Department of Physiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa 41110, Greece;5. Division of Basic Neurosciences, Biomedical Research Foundation of the Academy of Athens, Athens, Greece;6. Second Department of Neurology, National and Kapodistrian University of Athens Medical School, Athens, Greece |
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| Abstract: | ![]()
BackgroundEarly diagnosis of cognitive impairment in PD would allow appropriate monitoring and timely intervention to reduce the progression to dementia (PDD).ObjectiveTo study the usefulness of the Montreal Cognitive Assessment (MoCA) in the screening for mild cognitive impairment (PD-MCI) and its predictive utility in determining longitudinal cognitive decline in PD.MethodsProspective longitudinal study of patients with mild PD. PD-MCI and PDD was diagnosed based on the Movement Disorder taskforce (MDS) criteria. Receiver Operating Characteristic analyses and Cox regression analyses were performed.Results95 patients; mean age 66.37 (SD 7.86); mean H&Y score of 1.99 (SD 0.45) were studied. At baseline, 34 patients fulfilled the MDS criteria for PD-MCI. MoCA, compared to the MMSE had a high discriminatory power in detecting PD-MCI [Area Under Curve (AUC) of 0.912, p < 0.001]. A MoCA score of ≤26 provided a sensitivity of 93.1% for the diagnosis of PD-MCI. In the longitudinal cohort over 2 years, baseline MOCA was useful in predicting cognitive decline (AUC of 0.707, p = 0.05). With Cox regression analyses, a 1-point lower score on baseline MoCA was associated with a 34% increased risk of cognitive decline [Hazard ratio (HR) 1.34; 95% CI: 1.03–1.74: p = 0.029]. A baseline MoCA ≤26 was highly predictive of progressive cognitive decline (HR 3.47, 95% CI: 2.38–5.07; p < 0.01).ConclusionsMoCA is a reliable tool in predicting cognitive decline in early PD. A MoCA score of ≤26 significantly increases the risk for progressive cognitive decline. |
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| Keywords: | Parkinson's disease Dementia Cognitive functions |
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