Accuracy of the short-form Montreal Cognitive Assessment: Systematic review and validation.
Int J Geriatr Psychiatry
; 34(10): 1515-1525, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-31243810
ABSTRACT
INTRODUCTION:
Short-form versions of the Montreal Cognitive Assessment (SF-MoCA) are increasingly used to screen for dementia in research and practice. We sought to collate evidence on the accuracy of SF-MoCAs and to externally validate these assessment tools.METHODS:
We performed systematic literature searching across multidisciplinary electronic literature databases, collating information on the content and accuracy of all published SF-MoCAs. We then validated all the SF-MoCAs against clinical diagnosis using independent stroke (n = 787) and memory clinic (n = 410) data sets.RESULTS:
We identified 13 different SF-MoCAs (21 studies, n = 6477 participants) with differing test content and properties. There was a pattern of high sensitivity across the range of SF-MoCA tests. In the published literature, for detection of post stroke cognitive impairment, median sensitivity across included studies 0.88 (range 0.70-1.00); specificity 0.70 (0.39-0.92). In our independent validation using stroke data, median sensitivity 0.99 (0.80-1.00); specificity 0.40 (0.14-0.87). To detect dementia in older adults, median sensitivity 0.88 (0.62-0.98); median specificity 0.87 (0.07-0.98) in the literature and median sensitivity 0.96 (range 0.72-1.00); median specificity 0.36 (0.14-0.86) in our validation. Horton's SF-MoCA (delayed recall, serial subtraction, and orientation) had the most favorable properties in stroke (sensitivity 0.90, specificity 0.87, positive predictive value [PPV] 0.55, and negative predictive value [NPV] 0.93), whereas Cecato's "MoCA reduced" (clock draw, animal naming, delayed recall, and orientation) performed better in the memory clinic (sensitivity 0.72, specificity 0.86, PPV 0.55, and NPV 0.93).CONCLUSIONS:
There are many published SF-MoCAs. Clinicians and researchers using a SF-MoCA should be explicit about the content. For all SF-MoCA, sensitivity is high and similar to the full scale suggesting potential utility as an initial cognitive screening tool. However, choice of SF-MoCA should be informed by the clinical population to be studied.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Disfunção Cognitiva
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Testes de Estado Mental e Demência
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article