Solaphat Hemrungrojn1,2, Sookjaroen Tangwongchai3, Thammanard Charoenboon4, Muthita Panasawat5, Thitiporn Supasitthumrong3, Pisit Chaipresertsud6, Pacharaporn Maleevach7, Yuttachai Likitjaroen8, Kammant Phanthumchinda8, Michael Maes3,9,10. 1. Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, solaphat@hotmail.com. 2. Cognitive Fitness Research Group, Chulalongkorn University, Bangkok, Thailand, solaphat@hotmail.com. 3. Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 4. Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Prathumthani, Thailand. 5. Department of Psychiatry, Faculty of Medicine, Thammasat University, Prathumthani, Thailand. 6. Chao-Phraya-Abhaibhubejhr Hospital, Prachinburi, Thailand. 7. Angthong Hospital, Ang Thong, Thailand. 8. Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 9. Department of Psychiatry, Medical University of Plovdiv and Technological Center for Emergency Medicine, Plovdiv, Bulgaria. 10. IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia.
Abstract
BACKGROUND: The Montreal Cognitive Assessment (MoCA) is an effective and applicable screening instrument to confirm the diagnosis of amnestic mild cognitive impairment (aMCI) from patients with Alzheimer's disease (AD) and healthy controls (HCs). OBJECTIVES: This study aimed to determine the reliability and validity of the following: (a) Thai translation of the MoCA (MoCA-Thai) and (b) delineate the key features of aMCI based on the MoCA subdomains. METHODS: This study included 60 HCs, 61 aMCI patients, and 60 AD patients. The MoCA-Thai shows adequate psychometric properties including internal consistency, concurrent validity, test-retest validity, and inter-rater reliability. RESULTS: The MoCA-Thai may be employed as a diagnostic criterion to make the diagnosis of aMCI, whereby aMCI patients are discriminated from HC with an area under the receiver-operating characteristic (AUC-ROC) curve of 0.813 and from AD patients with an AUC-ROC curve of 0.938. The best cutoff scores of the MoCA-Thai to discriminate aMCI from HC is ≤24 and from AD > 16. Neural network analysis showed that (a) aberrations in recall was the most important feature of aMCI versus HC with impairments in language and orientation being the second and third most important features and (b) aberrations in visuospatial skills and executive functions were the most important features of AD versus aMCI and that impairments in recall, language, and orientation but not attention, concentration, and working memory, further discriminated AD from aMCI. CONCLUSIONS: The MoCA-Thai is an appropriate cognitive assessment tool to be used in the Thai population for the diagnosis of aMCI and AD.
BACKGROUND: The Montreal Cognitive Assessment (MoCA) is an effective and applicable screening instrument to confirm the diagnosis of amnestic mild cognitive impairment (aMCI) from patients with Alzheimer's disease (AD) and healthy controls (HCs). OBJECTIVES: This study aimed to determine the reliability and validity of the following: (a) Thai translation of the MoCA (MoCA-Thai) and (b) delineate the key features of aMCI based on the MoCA subdomains. METHODS: This study included 60 HCs, 61 aMCI patients, and 60 AD patients. The MoCA-Thai shows adequate psychometric properties including internal consistency, concurrent validity, test-retest validity, and inter-rater reliability. RESULTS: The MoCA-Thai may be employed as a diagnostic criterion to make the diagnosis of aMCI, whereby aMCI patients are discriminated from HC with an area under the receiver-operating characteristic (AUC-ROC) curve of 0.813 and from AD patients with an AUC-ROC curve of 0.938. The best cutoff scores of the MoCA-Thai to discriminate aMCI from HC is ≤24 and from AD > 16. Neural network analysis showed that (a) aberrations in recall was the most important feature of aMCI versus HC with impairments in language and orientation being the second and third most important features and (b) aberrations in visuospatial skills and executive functions were the most important features of AD versus aMCI and that impairments in recall, language, and orientation but not attention, concentration, and working memory, further discriminated AD from aMCI. CONCLUSIONS: The MoCA-Thai is an appropriate cognitive assessment tool to be used in the Thai population for the diagnosis of aMCI and AD.