Objective To evaluate diagnostic accuracy of several relevant cut-off points of Montreal cognitive assessment (MoCA) for mild cognitive impairment (MCI) in Chinese middle-aged adults. Methods Databases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 5, 2016), OVID, CBM, CNKI, VIP, WanFang Data were searched for diagnostic tests about MoCA for MCI from April 9th 2005 to December 31st 2015. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality by QUADAS-2 tool. Then, meta-analysis was performed by Stata 14.0 software. Results A total of 27 studies involving 5 755 participants were included with mean ages from 60 to 80 years old. Among them, 1 997 were diagnosed as MCI patients by Petersen criteria. Based on maximal area under the ROC curve as well as optimal pooled sensitivity and specificity, the optimal cutoff value of MoCA was 25/26, the pooled sensitivity was 0.96 with 95%CI 0.93 to 0.97, specificity was 0.83 with 95%CI 0.75 to 0.89, and DOR was 107 with 95%CI 61 to 188. The subgroup analysis with different research designs, different sources of study participants and different MoCA versions all indicated 25/26 as an optimal cut-off value. Conclusion The optimal cutoff value of MoCA in Chinese middle-aged adults for screening MCI by Petersen criteria was 25/26.
Objective
To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors.
Methods
The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed.
Results
The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01).
Conclusions
For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To explore the 2 year cognitive trajectory of patients with acute caudate head infarction and the impact of infarct volume on cognitive impairment. Methods We consecutively enrolled patients with acute caudate head infarction admitted to Xi’an Central Hospital between January 2014 and January 2022. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) at 1 week, 6-months, 12-months, 18-months and 24-months after admission. Infarct volume was measured via diffusion-weighted imaging. Spearman rank correlation was used to analyze the correlation between infarct volume and cognitive score changes; Friedman test with Bonferroni correction was applied for cross-time-point score comparison. Results A total of 25 patients completed the 24-months follow-up. The average was (62.08±8.90) years, the average infarct volume was (1 165.05±850.07) mm3. The average MoCA scores at the 5 time points were 20.40±4.46, 24.64±5.34, 24.48±5.65, 24.04±6.01 and 23.20±6.58. The average MMSE scores were 23.68±4.14, 26.92±4.33, 26.88±4.82, 26.76±4.85 and 26.32±5.04. The cognitive trajectory showed an initial rise followed by a decline within 24 months. MoCA score changes were strongly correlated with infarct volume (no significant correlation for MMSE). The difference in MoCA scores over the first 6 months was negatively correlated with infarct volume (P<0.001). 24-months MoCA changes were mainly attributed to visuospatial/executive function, language and delayed recall subdomains. Conclusion Caudate head infarct volume is associated with early-onset post-stroke cognitive impairment, with cognitive changes mainly driven by alterations in visuospatial/executive, language and delayed recall subdomains.
