Comparative study of two Chinese versions of Montreal Cognitive Assessment for Screening of Mild Cognitive Impairment.

Our aim was to compare the utility and accuracy of the Chinese Version of Montreal Cognitive Assessment Basic (MoCA-BC) and the Montreal Cognitive Assessment-Beijing Version (MoCA-BJ) in the identification of mild cognitive impairment (MCI) under different education levels. A sample of individuals with MCI (n = 295), Alzheimer's disease (AD; n = 254), and normal controls (NC; n = 259) at 2 Memory Clinics and communities was administered the MoCA-BC, MoCA-BJ, Mini-Mental State Examination (MMSE), and other neuropsychological tests. The discriminant validity of the MoCA-BC and MoCA-BJ as diagnostic instruments was ascertained. The overall discriminant validity for detection of MCI from NC (receiver operating characteristic area under the curve [95% confidence interval]) was that the MoCA-BC (0.95 [0.93, 0.97]) had better sensitivity and accuracy than MoCA-BJ (0.87 [0.84, 0.90]). In addition, we provide an easy to use table that enables the conversion of MoCA-BC to the MoCA-BJ scores or to MMSE scores. The MoCA-BC and MoCA-BJ provided good diagnostic accuracy when compared to MMSE. The MoCA-BC, which was proved to be an appropriate tool when screening for MCI among elderly subjects, can now be compared directly with the MoCA-BJ.

The items in the Chinese version of the Montreal cognitive assessment basic discriminate among different severities of Alzheimer's disease.

BACKGROUND: To determine whether items of the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) could discriminate among cognitively normal controls (NC), and those with mild cognitive impairment (MCI), mild Alzheimer's disease (AD), and moderate-severe (AD), as well as their sensitivity and specificity. METHODS: MCI (n = 456), mild AD (n = 502) and moderate-severe AD (n = 102) patients were recruited from the memory clinic, Huashan Hospital, Shanghai, China. NC (n = 329) were recruited from health checkup outpatients. Five MoCA-BC item scores were collected in interviews. RESULTS: The MoCA-BC orientation test had high sensitivity and specificity for discrimination among MCI, mild AD and moderate-severe AD. The delayed recall memory test had high sensitivity and specificity for MCI screening. The verbal fluency test was efficient for detecting MCI and differentiating AD severity. CONCLUSIONS: Various items of the MoCA-BC can identify MCI patients early and identify the severity of dementia.

Chinese version of Montreal Cognitive Assessment Basic for discrimination among different severities of Alzheimer's disease.

OBJECTIVES: To find out whether the Chinese version of Montreal Cognitive Assessment Basic (MoCA-BC) and its subtests could be applied in discrimination among cognitively normal controls (NC), mild cognitive impairment (MCI), mild and moderate Alzheimer's Disease (AD), and furthermore, to determine the optimal cutoffs most sensitive to distinguish between them. DESIGN: A cross-sectional validation study. SETTING: Huashan Hospital, Shanghai, China. PARTICIPANTS: There was a total of 1,969 participants: individuals with MCI (n=663), mild (n=345), moderate (n=441) AD, and cognitively NC (n=520) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China. MEASUREMENTS: Baseline MoCA-BC scores were collected from firsthand data. Two subtests were calculated from MoCA-BC: the Memory Index Score of MoCA-BC (MoCA-BC-MIS) and the Non-memory Index Score of MoCA-BC (MoCA-BC-NM). RESULTS: MoCA-BC was an effective cognitive tool to discriminate among NC, MCI, mild and moderate AD in the Chinese elderly across all education groups, implying that it was efficient not only for detecting MCI, but for different severities of AD as well. For MCI screening, the total score of MoCA-BC (MoCA-BC-T) and MoCA-BC-MIS had similar high sensitivity and specificity. For discrimination among MCI, mild and moderate AD, the MoCA-BC-T and MoCA-BC-NM had similar performance. CONCLUSION: MoCA-BC is an effective cognitive test to distinguish between NC, MCI, mild and moderate AD among the Chinese elderly with various levels of education.

Validation of the Chinese Version of Montreal Cognitive Assessment Basic for Screening Mild Cognitive Impairment.

OBJECTIVES: To evaluate the effectiveness of the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) as a screening tool for detecting mild cognitive impairment (MCI) in Chinese elderly adults. DESIGN: Cross-sectional. SETTING: Huashan Hospital, Shanghai, China. PARTICIPANTS: Individuals with MCI (n = 264) and mild Alzheimer's disease (AD) (n = 160) were recruited from the Memory Clinic, Huashan Hospital; cognitively normal controls were recruited from Jinshan Community, Shanghai, China (n = 280). MEASUREMENTS: MoCA-BC scores. RESULTS: The MoCA-BC had good criterion-related validity (Pearson correlation coefficient MoCA-BC vs MMSE = 0.787) and reliable internal consistency (Cronbach alpha = 0.807). The optimal cutoff scores for MCI screening were 19 for individuals with no more than 6 years of education, 22 for individuals with 7 to 12 years of education, and 24 for individuals with more than 12 years of education. The MoCA-BC was superior to the MMSE for detecting MCI, with optimal sensitivity and specificity across all education groups using the above cutoff scores. CONCLUSION: The MoCA-BC is a reliable cognitive screening test across all education levels in Chinese elderly adults, with high acceptance and good reliability.

[Eco-environmental quality assessment of Luoyuan Bay, Fujian province of East China based on biotic indices].

In this paper, two types of eco-environmental quality assessment indices that have been successively applied abroad, i.e., the AZTI marine biotic index (AMBI) and BENTIX index based on the ecological sensitivity of benthos and the multivariate-AMBI (M-AMBI), a multivariate index integrating AMBI, Shannon Index H', and species richness, were applied to assess the eco-environmental quality of Luoyuan Bay, Fujian Province of East China, and the assessment results were compared with those by the H', an index based on community structure, which is often applied in China, aimed to test the applicability of these indices to the Bay, and to provide reference in selecting the indices for assessing our coastal eco-environment quality. Similar assessment results were obtained by applying AMBI and BENTIX index, and M-AMBI and H'. At most stations (13 of 16), the assessment results by applying AMBI and BENTIX index, M-AMBI and H' were coincident, respectively; while at the other 3 stations, the assessment grade was high or good based on AMBI and BENTIX index, but moderate based on M-AMBI and H'. Taking account of the richness, individual abundance, and ecological group composition of the benthos in Luoyuan Bay, the assessment results based on M-AMBI and H' could be more reasonable. It was suggested that for the Luoyuan Bay which has a high level of eutrophication and low organic matter enrichment in sediment and is dominated by sensitive benthos species, M-AMBI and H' could be more applicative and objective than AMBI and BENTIX index in assessing its eco-environmental quality.

[An approach for integrated assessment of eco-risk in coastal waters based on catastrophe theory: taking Luoyuan Bay as a case].

Based on catastrophe theory, this paper established an index system and catastrophe progression model for the integrated assessment of eco-risk in coastal waters, including three risk types of "eutrophication-heavy metal pollution-organic pollution" and three dimensions of "water-sediment-organism". According to the related quality standards, a four-level evaluation standard of eco-risk (zero, low, medium, and high) was proposed, and by using the monitoring data of 2007 and 2009, an integrated assessment of the eco-risk in Luoyuan Bay was conducted. In 2007-2009, the spatial variation of the eco-risk in Luoyuan Bay had a downward trend from bayhead to baymouth, and the risk level in 2009 was overall lower than that in 2007. The key factor of the eco-risk in the Bay was eutrophication. The approach established in this paper could identify the spatiotemporal variation characteristics of eco-risk in coastal waters, and better reflect the key eco-risk factor, providing a basic approach for effective forecasting and early warning of eco-risk in coastal waters.

[An integrated assessment method of ecological quality status in coastal waters: taking Tong'an Bay as a case].

Based on the integrated assessment methods of ecological quality status (EcoQS) in coastal waters abroad as well as the domestic related research status, 11 indices were selected from the biotic and physicochemical elements of water and sediment to built an integrated EcoQS assessment index system, and, with the comprehensive consideration of domestic and international evaluation standards, 5 levels of EcoQS classified as "high, good, moderate, poor, and bad" were determined. Then, an integrated assessment method of EcoQS in coastal waters was established by using analytic hierarchy process (AHP) and fuzzy mathematics method, and tested by the analysis of the correlations between the EcoQS grade and the major anthropogenic disturbances and pollutant concentrations of Tong' an Bay. The EcoQS of Tong' an Bay was assessed as moderate, i.e., the Bay was moderately disturbed and in transitional to poor status. The established integrated assessment method could not only reflect the major anthropogenic environmental pressure and risk factors, but also give an early warning of the pollutants satisfied by law in the study area.