Validity and diagnostics of the Italian version of the Montreal Cognitive Assessment (MoCA) in non-demented Parkinson’s disease patients,Aging Clinical and Experimental Research

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Validity and diagnostics of the Italian version of the Montreal Cognitive Assessment (MoCA) in non-demented Parkinson’s disease patients
Aging Clinical and Experimental Research ( IF 3.4 ) Pub Date : 2023-07-22 , DOI: 10.1007/s40520-023-02493-w
Alfonsina D'Iorio ₁ , Edoardo Nicolò Aiello ₂ , Marianna Amboni _{3,

4} , Carmine Vitale _{3,

5} , Federico Verde _{2,

6} , Vincenzo Silani _{2,

6} , Nicola Ticozzi _{2,

6} , Andrea Ciammola ₂ , Barbara Poletti _{2,

7} , Gabriella Santangelo ₁

Affiliation

Background

This study aimed at: (1) assessing, in an Italian cohort of non-demented Parkinson’s disease (PD) patients, the construct validity of the Montreal Cognitive Assessment (MoCA) against both first- and second-level cognitive measures; (2) delivering an exhaustive and updated evaluation of its diagnostic properties.

Methods

A retrospective cohort of N = 237 non-demented PD patients having been administered the MoCA was addressed, of whom N = 169 further underwent the Mini-Mental State Examination (MMSE) and N = 68 the Parkinson’s Disease Cognitive Rating Scale (PD-CRS). A subsample (N = 60) also underwent a second-level cognitive battery encompassing measures of attention/executive functioning, language, memory, praxis and visuo-spatial abilities. Construct validity was assessed against both the PD-CRS and the second-level cognitive battery. Diagnostics were tested via receiver-operating characteristics analyses against a below-cut-off MMSE score.

Results

The MoCA was associated with both PD-CRS scores (p < .001) and the vast majority of second-level cognitive measures (ps < .003). Both raw and adjusted MoCA scores proved to be highly accurate to the aim of identifying patients with MMSE-confirmed cognitive dysfunctions. A MoCA score adjusted for age and education according to the most recent normative dataset and < 19.015 is herewith suggested as indexing cognitive impairment in this population (AUC = .92; sensitivity = .92; specificity = .80).

Discussion

The Italian MoCA is a valid and diagnostically sound screener for global cognitive inefficiency in non-demented PD patients. Further studies are nevertheless needed that confirm its diagnostic values against a measure other than the MMSE.

中文翻译：

意大利版蒙特利尔认知评估 (MoCA) 在非痴呆帕金森病患者中的有效性和诊断

背景

本研究的目的是：（1）在意大利非痴呆帕金森病（PD）患者队列中评估蒙特利尔认知评估（MoCA）针对一级和二级认知测量的结构有效性；(2)对其诊断特性进行详尽且最新的评估。

方法

对接受 MoCA 治疗的N = 237 名非痴呆帕金森病患者进行回顾性队列研究，其中N = 169 名进一步接受简易精神状态检查 (MMSE)，N = 68 名接受帕金森病认知评定量表 (PD-CRS) ）。子样本（N = 60）还接受了二级认知测试，包括注意力/执行功能、语言、记忆、实践和视觉空间能力的测量。根据 PD-CRS 和二级认知电池评估结构有效性。通过针对低于截止值的 MMSE 评分进行接收者操作特征分析来测试诊断结果。

结果

MoCA 与 PD-CRS 评分 ( p < .001) 和绝大多数二级认知测量 ( p s < .003)相关。事实证明，原始 MoCA 评分和调整后的 MoCA 评分对于识别 MMSE 确认的认知功能障碍患者的目的都非常准确。根据最新规范数据集根据年龄和教育程度调整 MoCA 评分，并且 < 19.015 在此建议作为该人群认知障碍的索引（AUC = .92；敏感性 = .92；特异性 = .80）。