Comparison of the Montreal Cognitive Assessment (MoCA) between Patients with Parkinson’s Disease and Parkinson’s Disease Dementia
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Abstract
Objective: This study is aimed to compare the characteristics of scores from the Montreal Cognitive Assessment (MoCA) between Parkinson's disease patients (PD) and patients with Parkinson's disease with dementia (PDD), in order to determine the sensitivity, specificity, and appropriate cutoff scores of the MoCA for distinguishing dementia in PD patients.
Methods: This retrospective study utilized data from the medical records of PD patients who were receiving treatments at the outpatient department of the Neurological Institute of Thailand from January 2017 to December 2021. There is a total of 98 patients, where 56 patients had PD and 42 had PDD. All patients were assessed using the measurements of Thai Mental State Examination (TMSE) and the Montreal Cognitive Assessment (MoCA).
Results: Significant differences were found between the two groups when comparing the total MoCA scores. Differences in average scores were found in almost all cognitive domains, with the PD group scoring higher in visuospatial, immediate memory, delayed memory, attention, language, and orientation domains compared to the PDD group. However, no significant differences between the two groups were found in naming and abstraction domains. As a result, MoCA was found to be an effective tool for differentiating PD from PDD groups, with an appropriate cutoff score of ≤ 16 points (sensitivity 74%, specificity 82%).
Conclusion: These cognitive domains, such as, complex attention, executive and visuo-spatial functions, and delayed memory, could potentially serve as pivotal components in evaluating cognitive impairment among patients with PDD.
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References
Bhidayasiri R. Thai national formulary 2019 drugs used in Parkinson's disease. Bangkok: Aksorn Graphic and Design Publishing House; 2019.
Bhidayasiri R, Phanthumchinda K, Bunnag S. Parkinson's disease is treatable. 3rd. Bangkok: Chulalongkorn Center of Excellence for Parkinson's Disease and Related Movement Disorders; 2006.
Jitkritsadakul O, Bhidayasiri R. Neurological Perspectives of Parkinson's disease surgery. Bangkok: Chulalongkorn Center of Excellence for Parkinson's Disease and Related Movement Disorders; 2018.
Aarsland D, Cummings J, Weintraub D,Chaudhuri R. Neuropsychiatric and cognitive changes in Parkinson's disease and related movement disorders. New York: Cambridge University Press; 2013.
Hommanee N, Lolekha P. The comparative study of cognitive profiles using the Montreal Cognitive Assessment (MOCA) in Thai patients with Parkinson's disease and elderly subjects with and without dementia. Thai Journal of Neurology 2016; 32(1): 18-27.
Kim H, Nazor C, Zabetian C, Quinn J, Chung K, Hiller A, et al. Prediction of cognitive progression in Parkinson’s disease using three cognitive screening measures. Clin Park Relat Disord 2019; 1: 91-7.
Poewe W, Gauthier S, Aarsland D, Leverenz J, Barone P, Weintraub D, et al. Diagnosis and management of Parkinson’s disease dementia. Int J Clin Pract 2008; 62(10): 1581–7.
Janvin C, Aarsland D, Larsen J, Hugdahl K. Neuropsychological profile of patients with Parkinson’s disease without dementia. Dement Geriatr Cogn Disord 2003; 15(3): 126–31.
Emre M, Aarsland D, Brown R, Burn D, Duyckaerts C, Mizuno Y, et al. Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 2007; 22(12):1689–707.
Backstrom D, Granasen G, Domellof M, Linder J, Jakobson S, Riklund K, et al. Early predictors of mortality in parkinsonism and Parkinson disease: a population-based study. Neurol Genet 2018; 91(22): 2045–56.
Chou K, Lenhart A, Koeppe R, Bohnen N. Abnormal MoCA and normal range MMSE scores in Parkinson disease without dementia: Cognitive and neurochemical correlates. Parkinsonism Relat Disord 2014; 20(10): 1076–80.
Vásquez K, Valverde E, Aguilar D, Gabarain H. Montreal Cognitive Assessment scale in patients with Parkinson disease with normal scores in the Mini-Mental State Examination. Dement Neuropsychol 2019; 13(1): 78–81.
Fengler S, Kessler J, Timmermann L, Zapf A, Elben S, Wojtecki L, et al. Screening for cognitive impairment in Parkinson’s disease: Improving the diagnostic utility of the MoCA through subtest weighting. PLoS One 2016; 11(7): e0159318.
Lucza T, Karádi K, Kállai J, Weintraut R, Janszky J, Makkos A, et al. Screening mild and major neurocognitive disorders in Parkinson’s disease. Behav Neurol 2015; 2015: 983606.
Henderson E, Chu H, Gaunt D, Whone A, Ben-Shlomo Y, Lyell V. Comparison of test your memory and Montreal cognitive assessment measures in Parkinson’s disease. Parkinsons Dis 2016; 2016: 1012847.
Gill D, Freshman A, Blender J, Ravina B. The Montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson’s disease. Mov Disord 2008; 23(7): 1043-6.
Hemrungrojn S, Tangwongchai S, Charoenboon T, Panasawat M, Supasitthumrong T, Chaipresertsud P, et al. Use of the Montreal Cognitive Assessment Thai version (MoCA) to discriminate amnestic mild cognitive impairment from Alzheimer’s disease and healthy controls: machine learning results. Dement Geriatr Cogn Disord. 2021; 50(2): 183-94.
Nasreddine Z, Phillips N, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695–9.
Brønnick K, Emre M, Lane R, Tekin S, Aarsland D. Profile of cognitive impairment in dementia associated with Parkinson’s disease compared with Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2007; 78(10): 1064–8.