MoCa predictive power in neuropsychological assessment of patients with
                  dementia

Cecato, Juliana Francisca; Montiel, José Maria; Bartholomeu, Daniel; Martinelli, José Eduardo

doi:10.1590/1809-9823.2014.13123

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Artigos Originais • Rev. bras. geriatr. gerontol. 17 (4) • Oct-Dec 2014 • https://doi.org/10.1590/1809-9823.2014.13123 copy

MoCa predictive power in neuropsychological assessment of patients with dementia

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study aimed to correlate neuropsicometric tests in elderly over 4 years of schooling and assess MoCA accuracy in diagnosing Alzheimer's disease and mild cognitive impairment (MCI). It evaluated 136 elderly patients treated at the Institute of Geriatrics and Gerontology, from April 2010 to December 2012. The instruments used were the Mini-Mental State Examination (MMSE), Cambridge Cognitive Examination (CAMCOG), Clock Drawing Test (CDT), Verbal Fluency test, Geriatric Depression Scale, Pfeffer Functional Activities Questionnaire (PFAQ), and Montreal Cognitive Assessement (MoCA). ROC curve analysis was used to establish cutoffs and the Pearson correlation coefficient to compare the MoCA with the other tests. The results showed that the MoCA was the best test to differentiate Alzheimer's disease from MCI. The sensitivity and specificity found were 82.2% and 92.3%, respectively. The analysis of the correlation test showed that MoCA is strongly correlated with other tests already validated and wide applied in Brazil. The MoCA test showed the greatest predictive value to differentiate AD from MCI and also differ MCI from normal controls. Furthermore, MoCA was significantly correlated with the age variable and MMSE, CAMCOG, CDT, Verbal Fluency and PFAQ tests, instruments that are already validated and widely used in Brazil.

Psychological Assessment; Neuropsychological Assessment; Neuropsychology; Psychodiagnostic; Learning

	CCL	C	Sensibilidade		Especificidade		ASC	p
	n	n	IC 95%		IC 95%		ASC	p
MoCA								< 0,0001
<25	37	3	82,2%		92,3%		0,943
>=25	8	36	71,1%	93,4%	83,9%	100,0%
CAMCOG								< 0,0001
<92	30	4	66,7%		89,7%		0,8621
>=92	15	35	52,9%	80,4%	80,2%	99,3%
GDS								0,2044
>=2	27	18	60,0%		53,8%		0,5729
<2	18	21	45,7%	74,3%	38,2%	69,5%
MEEM								< 0,0001
<29	36	7	80,0%		82,1%		0,8322
>=29	9	32	68,3%	91,7%	70,0%	94,1%
Mendez								0,0049
<20	30	14	66,7%		64,1%		0,6781
>=20	15	25	52,9%	80,4%	49,0%	79,2%
PFAQ								< 0,0001
>=1	34	9	75,6%		76,9%		0,7752
<1	11	30	63,0%	88,1%	63,7%	90,1%
Shulman								0,0045
<5	29	13	64,4%		66,7%		0,6658
>=5	16	26	50,5%	78,4%	51,9%	81,5%

	DA	C	Sensibilidade		Especificidade		ASC	p
	n	n	IC 95%		IC 95%		ASC	p
MoCA								< 0,0001
<23	51	0	98,1%		100,0%		0,9993
>=23	1	39	94,3%	101,8%	100,0%	100,0%
CAMCOG								< 0,0001
<90	47	1	90,4%		97,4%		0,9712
>=90	5	38	82,4%	98,4%	92,5%	102,4%
GDS								0,4232
>=3	23	14	44,2%		64,1%		0,5754
<3	29	25	30,7%	57,7%	49,0%	79,2%
MEEM								< 0,0001
<29	48	7	92,3%		82,1%		0,9522
>=29	4	32	85,1%	99,6%	70,0%	94,1%
Mendez								< 0,0001
<19	33	4	63,5%		89,7%		0,8119
>=19	19	35	50,4%	76,5%	80,2%	99,3%
PFAQ								< 0,0001
>=2	46	6	88,5%		84,6%		0,9453
<2	6	33	79,8%	97,1%	73,3%	95,9%
Shulman								< 0,0001
<5	43	13	82,7%		66,7%		0,8141
>=5	9	26	72,4%	93,0%	51,9%	81,5%

Universidade do Estado do Rio Janeiro Rua São Francisco Xavier, 524 - Bloco F, 20559-900 Rio de Janeiro - RJ Brasil, Tel.: (55 21) 2334-0168 - Rio de Janeiro - RJ - Brazil
E-mail: revistabgg@gmail.com

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[1] Correspondência / Correspondence José Maria Montiel E-mail: montieljm@hotmail.com