PURPOSE: Use Taiwanese version of the Montreal Cognitive Assessment (MoCA) in evaluating patients in different stages of Alzheimer's disease (AD) and correlate with white matter change. METHODS: Ninety-seven normal controls (NC), 52 very-mild AD (clinical dementia rating [CDR] = 0.5), 48 mild AD (CDR = 1) and 38 moderate AD (CDR = 2) patients were enrolled for the MoCA, Mini- Mental State Examination (MMSE) and the Cognitive Assessment Screening Instrument (CASI). White matter hyperintensities (WMHs) on brain MRI were visually rated and classified as deep or periventricular WMHs. RESULTS: In NC group, education (β = 0.326) but not age (β = -0.183, p = 0.069), was significantly related to MoCA score. However, while we added two points to the AD patients with less than 6 years education, the effects of education disappeared as compared with those of 7 years of education. For all educational levels, the cutoff value of MoCA for very-mild AD was 22/23 (sensitivity = 82.7%, specificity = 87.6%). No significant differences were found in the areas under the curves that differentiated NC from the patients with AD for MoCA and MMSE (differences = 0.008, p = 0.490), or for MoCA and CASI (differences = 0.023, p = 0.082). Total WMHs, frontal deep and periventricular WMHs were inversely correlated with the attention and delayed-recall subdomain. CONCLUSION: The MoCA is a good clinical tool for screening very-mild stage AD if the educational effects are carefully considered. The correlation between the executive subdomains with the frontal WMHs also makes it a useful tool for detecting subtle WMHs.
PURPOSE: Use Taiwanese version of the Montreal Cognitive Assessment (MoCA) in evaluating patients in different stages of Alzheimer's disease (AD) and correlate with white matter change. METHODS: Ninety-seven normal controls (NC), 52 very-mild AD (clinical dementia rating [CDR] = 0.5), 48 mild AD (CDR = 1) and 38 moderate AD (CDR = 2) patients were enrolled for the MoCA, Mini- Mental State Examination (MMSE) and the Cognitive Assessment Screening Instrument (CASI). White matter hyperintensities (WMHs) on brain MRI were visually rated and classified as deep or periventricular WMHs. RESULTS: In NC group, education (β = 0.326) but not age (β = -0.183, p = 0.069), was significantly related to MoCA score. However, while we added two points to the ADpatients with less than 6 years education, the effects of education disappeared as compared with those of 7 years of education. For all educational levels, the cutoff value of MoCA for very-mild AD was 22/23 (sensitivity = 82.7%, specificity = 87.6%). No significant differences were found in the areas under the curves that differentiated NC from the patients with AD for MoCA and MMSE (differences = 0.008, p = 0.490), or for MoCA and CASI (differences = 0.023, p = 0.082). Total WMHs, frontal deep and periventricular WMHs were inversely correlated with the attention and delayed-recall subdomain. CONCLUSION: The MoCA is a good clinical tool for screening very-mild stage AD if the educational effects are carefully considered. The correlation between the executive subdomains with the frontal WMHs also makes it a useful tool for detecting subtle WMHs.
Authors: Daniel H J Davis; Sam T Creavin; Jennifer L Y Yip; Anna H Noel-Storr; Carol Brayne; Sarah Cullum Journal: Cochrane Database Syst Rev Date: 2015-10-29
Authors: Miguel A Chávez-Fumagalli; Pallavi Shrivastava; Jorge A Aguilar-Pineda; Rita Nieto-Montesinos; Gonzalo Davila Del-Carpio; Antero Peralta-Mestas; Claudia Caracela-Zeballos; Guillermo Valdez-Lazo; Victor Fernandez-Macedo; Alejandro Pino-Figueroa; Karin J Vera-Lopez; Christian L Lino Cardenas Journal: J Alzheimers Dis Rep Date: 2021-01-11
Authors: Daniel Hj Davis; Samuel T Creavin; Jennifer Ly Yip; Anna H Noel-Storr; Carol Brayne; Sarah Cullum Journal: Cochrane Database Syst Rev Date: 2021-07-13