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Montreal Cognitive Assessment (MoCA) Performance and Domain-Specific Index Scores in Amnestic Versus Aphasic Dementia

Published online by Cambridge University Press:  19 May 2020

Jessica L. Wood Open the ORCID record for Jessica L. Wood [Opens in a new window] ,
Sandra Weintraub ,
Christina Coventry ,
Jiahui Xu ,
Hui Zhang ,
Emily Rogalski ,
Marek-Marsel Mesulam  and
Tamar Gefen
Jessica L. Wood*
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Sandra Weintraub
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Christina Coventry
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Jiahui Xu
Affiliation:
Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Quantitative Data Sciences Core (QDSC), Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Hui Zhang
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Quantitative Data Sciences Core (QDSC), Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Emily Rogalski
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Marek-Marsel Mesulam
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Tamar Gefen
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
*
*Correspondence and reprint requests to: Jessica L. Wood, BA, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, 300 East Superior Street Tarry – 8, Chicago, IL60611, USA. E-mail: [email protected]
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Abstract

Objective:

The Montreal Cognitive Assessment (MoCA) is a popular and simple-to-administer screening instrument to detect cognitive impairment. The MoCA generates a total score and six domain-specific index scores: (1) Memory, (2) Executive Functioning, (3) Attention, (4) Language, (5) Visuospatial, and (6) Orientation. It is unclear whether these MoCA scores can differentiate between distinct clinical dementia syndromes. This study compared MoCA Index scores between amnestic dementia of the Alzheimer’s type (DAT) and primary progressive aphasia (PPA), a language-based dementia.

Method:

Baseline MoCA data were analyzed from 33 DAT, 37 PPA, and 83 cognitively normal individuals enrolled in the Clinical Core of the Northwestern Alzheimer’s Disease Center. A one-way analysis of covariance adjusted for age was used to compare MoCA scores among groups. A logistic regression model was implemented to observe individual likelihood of group affiliation based on MoCA Index scores.

Results:

The mean MoCA total score was significantly higher in controls compared to both patient groups (p < .001) but did not differ between DAT and PPA groups. However, in accordance with salient clinical features commonly observed in DAT versus PPA, Memory and Orientation Index scores were lowest in the DAT group (p < .001), whereas Language and Attention Index scores were lowest in the PPA group (p < .001). Multivariate logistic regression analysis showed that the individual effects of Memory (p = .001), Language (p = .002), and Orientation (p = .025) Indices were significant.

Conclusions:

MoCA Index scores can help differentiate among distinct cognitive syndromes, suggesting it may be a useful brief screening tool to detect domain-specific cognitive impairment.

Keywords

Primary progressive aphasiaAlzheimer’s diseaseCognitionAssessmentNeurodegenerationDementias
Type
Brief Communication
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 9 , October 2020 , pp. 927 - 931
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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References

Dickerson, B.C., McGinnis, S.M., Xia, C., Price, B.H., Atri, A., Murray, M.E., … Wolk, D.A. (2017). Approach to atypical Alzheimer’s disease and case studies of the major subtypes. CNS Spectrums, 22(6), 439–449. doi: 10.1017/S109285291600047XCrossRefGoogle ScholarPubMed
Gauthier, S., Reisberg, B., Zaudig, M., Petersen, R.C., Ritchie, K., Broich, K., … International Psychogeriatric Association Expert Conference on Mild Cognitive, i. (2006). Mild cognitive impairment. Lancet, 367(9518), 1262–1270. doi: 10.1016/S0140-6736(06)68542-5CrossRefGoogle ScholarPubMed
Gefen, T., Gasho, K., Rademaker, A., Lalehzari, M., Weintraub, S., Rogalski, E., … Mesulam, M.M. (2012). Clinically concordant variations of Alzheimer pathology in aphasic versus amnestic dementia. Brain, 135(Pt 5), 1554–1565. doi: 10.1093/brain/aws076CrossRefGoogle ScholarPubMed
Goldstein, F.C., Milloy, A., & Loring, D.W. (2018). Incremental validity of Montreal cognitive assessment index scores in mild cognitive impairment and Alzheimer disease. Dementia and Geriatric Cognitive Disorders, 45(1–2), 49–55. doi: 10.1159/000487131CrossRefGoogle ScholarPubMed
Hebert, L.E., Weuve, J., Scherr, P.A., & Evans, D.A. (2013). Alzheimer disease in the United States (2010-2050) estimated using the 2010 census. Neurology, 80(19), 1778–1783. doi: 10.1212/WNL.0b013e31828726f5CrossRefGoogle ScholarPubMed
Johnson, N., Barion, A., Rademaker, A., Rehkemper, G., & Weintraub, S. (2004). The activities of daily living questionnaire: A validation study in patients with dementia. Alzheimer Disease and Associated Disorders, 18(4), 223–230. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15592135Google ScholarPubMed
Julayanont, P., Brousseau, M., Chertkow, H., Phillips, N., & Nasreddine, Z.S. (2014). Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer’s disease. Journal of the American Geriatrics Society, 62(4), 679–684. doi: 10.1111/jgs.12742CrossRefGoogle ScholarPubMed
Kaur, A., Edland, S.D., & Peavy, G.M. (2018). The MoCA-Memory Index Score: An efficient alternative to paragraph recall for the detection of Amnestic mild cognitive impairment. Alzheimer Disease and Associated Disorders, 32(2), 120–124. doi: 10.1097/WAD.0000000000000240CrossRefGoogle ScholarPubMed
Konishi, S. & Kitagawa, G. (2008). Information Criteria and Statistical Modeling. Information Criteria and Statistical Modeling, 1–273. doi: 10.1007/978-0-387-71887-3CrossRefGoogle Scholar
McKhann, G.M., Knopman, D.S., Chertkow, H., Hyman, B.T., Jack, C.R. Jr., Kawas, C.H., … Phelps, C.H. (2011). The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement, 7(3), 263–269. doi: 10.1016/j.jalz.2011.03.005CrossRefGoogle Scholar
Mesulam, M.M. (2003). Primary progressive aphasia–A language-based dementia. New England Journal of Medicine, 349(16), 1535–1542. doi: 10.1056/NEJMra022435CrossRefGoogle Scholar
Morris, J.C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43(11), 2412–2414. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/8232972CrossRefGoogle ScholarPubMed
Nasreddine, Z.S., Phillips, N.A., Bedirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699. doi: 10.1111/j.1532-5415.2005.53221.xCrossRefGoogle ScholarPubMed
Osher, J.E., Wicklund, A.H., Rademaker, A., Johnson, N., & Weintraub, S. (2007). The mini-mental state examination in behavioral variant frontotemporal dementia and primary progressive aphasia. American Journal of Alzheimer’s Disease and Other Dementias, 22(6), 468–473. doi: 10.1177/1533317507307173CrossRefGoogle ScholarPubMed
Petersen, R.C., Lopez, O., Armstrong, M.J., Getchius, T.S.D., Ganguli, M., Gloss, D., … Rae-Grant, A. (2018). Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American academy of neurology. Neurology, 90(3), 126–135. doi: 10.1212/WNL.0000000000004826CrossRefGoogle ScholarPubMed
Petersen, R.C., Roberts, R.O., Knopman, D.S., Boeve, B.F., Geda, Y.E., Ivnik, R.J., … Jack, C.R Jr. (2009). Mild cognitive impairment: ten years later. Archives of Neurology, 66(12), 1447–1455. doi: 10.1001/archneurol.2009.266CrossRefGoogle ScholarPubMed
Rogalski, E., Sridhar, J., Rader, B., Martersteck, A., Chen, K., Cobia, D., … Mesulam, M.M. (2016). Aphasic variant of Alzheimer disease: Clinical, anatomic, and genetic features. Neurology, 87(13), 1337–1343. doi: 10.1212/WNL.0000000000003165CrossRefGoogle ScholarPubMed
Weintraub, S., Besser, L., Dodge, H.H., Teylan, M., Ferris, S., Goldstein, F.C., … Morris, J.C. (2018). Version 3 of the Alzheimer Disease Centers’ Neuropsychological Test Battery in the Uniform Data Set (UDS). Alzheimer Disease and Associated Disorders, 32(1), 10–17. doi: 10.1097/WAD.0000000000000223CrossRefGoogle Scholar
Weintraub, S., Rogalski, E., Shaw, E., Sawlani, S., Rademaker, A., Wieneke, C., & Mesulam, M.M. (2013). Verbal and nonverbal memory in primary progressive aphasia: The three words-three shapes test. Behavioural Neurology, 26(1–2), 67–76. doi: 10.3233/BEN-2012-110239CrossRefGoogle ScholarPubMed
Weintraub, S., Wicklund, A.H., & Salmon, D.P. (2012). The neuropsychological profile of Alzheimer disease. Cold Spring Harbor Perspectives in Medicine, 2(4), a006171. doi: 10.1101/cshperspect.a006171CrossRefGoogle ScholarPubMed