Shortened versions of Montreal Cognitive Assessment (MOCA) are feasible for screening of mild cognitive impairment and dementia: a systematic review and meta-analysis of 33 cross-sectional studies
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The Montreal Cognitive Assessment (MoCA) is a cognitive screening test for the detection of cognitive impairment. The questions of MoCA cover multiple cognitive domains, but the interview with MoCA takes administration time from healthcare professionals. The objective of this study is to investigate the screening performance of different domains and possible shortened versions of MoCA.
This study is a systematic review and meta‐analysis. Cross‐sectional studies using MoCA to assess cognitive impairment among patients with MCI or dementia were identified from OVID databases until Oct 2018. The questions from MoCA were categorized into seven domains, including memory, visuospatial abilities, language, attention, orientation, abstraction, and naming. The outcomes of this study were the changes in scores for the cognitive questions of MoCA between the patients with MCI or dementia and those with normal cognition. Standardized mean difference (SMD) with 95% confidence interval (95% CI) was used. SMDs were combined with meta‐analysis. Risk of bias and quality of included studies were assessed. Subgroup analyses were conducted for different types of cognitive impairment.
A total of 33 studies with 4,528 participants were included. The questions on memory and visuospatial abilities were more sensitive to detect MCI (SMD = −1.29, 95% CI = −1.47 to −1.11, and SMD = −1.14, 95% CI = −1.35 to −0.93, respectively), while the questions on naming was less sensitive (SMD = −0.33, 95% CI = −0.48 to ‐0.18). A shortened version of MoCA without questions on naming showed an identical diagnostic performance with full‐MoCA in the detection of MCI (SMD = −2.22, 95% CI = −2.47 to −1.98, and SMD = −2.22, 95% CI = −2.47 to −1.97, respectively). Similar results were found in the detection of dementia. In subgroup analysis, the questions on orientation was more important to detect Alzheimer's disease.
The shortened versions of MoCA without questions on naming showed to have comparable performance with the full‐MoCA. Questions for memory and visuospatial abilities are more sensitive to detect MCI and dementia. The shortened versions of MoCA will play an important role to reduce the workload of healthcare professionals on screening for cognitive impairment.
All Author(s) ListChan JYC, Tsoi KKF, Chan TK, Wong A, Kwok TCY, Wong SYS
Name of ConferenceAlzheimer's Association International Conference 2019
Start Date of Conference14/07/2019
End Date of Conference18/07/2019
Place of ConferenceLos Angeles
Country/Region of ConferenceUnited States of America
Proceedings TitleAlzheimer's and Dementia
Volume Number15
Issue Number7S
Pages962 - 966
LanguagesEnglish-United Kingdom

Last updated on 2021-19-09 at 23:29