대한치매학회지 (Dementia and Neurocognitive Disorders)

대한치매학회 (Korean Dementia Association)
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Differential Validity of K-MoCA-22 Compared to K-MoCA-30 and K-MMSE for Screening MCI and Dementia

  • Haeyoon Kim (Department of Psychology, Hallym University) ;
  • Kyung-Ho Yu (Department of Neurology, Hallym University Sacred Heart Hospital) ;
  • Yeonwook Kang (Department of Psychology, Hallym University)
  • 투고 : 2024.10.03
  • 심사 : 2024.10.20
  • 발행 : 2024.10.31
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초록

Background and Purpose: Since the onset of the coronavirus disease 2019 pandemic, the Telephone-Montreal Cognitive Assessment (T-MoCA) has gained popularity as a remote cognitive screening tool. T-MoCA includes items from the original MoCA (MoCA-30), excluding those requiring visual stimuli, resulting in a maximum score of 22 points. This study aimed to assess whether the T-MoCA items (MoCA-22) demonstrate comparable discriminatory power to MoCA-30 and Mini-Mental State Examination (MMSE) in screening for mild cognitive impairment (MCI) and dementia. Methods: Participants included 233 cognitively normal (CN) individuals, 175 with MCI, and 166 with dementia. All completed the Korean-MoCA-30 (K-MoCA-30) and Korean-MMSE (K-MMSE), with the Korean-MoCA-22 (K-MoCA-22) scores derived from the K-MoCA-30 responses. A receiver operating characteristic (ROC) curve analysis was conducted. Results: K-MoCA-22 showed a strong correlation with K-MoCA-30 and a moderate correlation with K-MMSE. Scores decreased progressively from CN to MCI and dementia, with significant differences between groups, consistent with K-MoCA-30 and K-MMSE. The study also explored modified K-MoCA-22 index scores across 5 cognitive domains. ROC curve analysis revealed that the area under the curve (AUC) for K-MoCA-22 was significantly smaller than that for K-MoCA-30 in distinguishing both MCI and dementia from CN. However, no significant difference in AUC was found between K-MoCA-22 and K-MMSE, indicating similar discriminatory power. Additionally, the discriminability of K-MoCA-22 varied by education level. Conclusions: These results indicate that K-MoCA-22, although slightly less effective than K-MoCA-30, still shows good to excellent discriminatory power and is comparable to K-MMSE in screening for MCI and dementia.

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참고문헌

  1. Nasreddine ZS, Phillips NA, 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;53:695-699.
  2. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
  3. Hachinski V, Iadecola C, Petersen RC, Breteler MM, Nyenhuis DL, Black SE, et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke 2006;37:2220-2241.
  4. Julayanont P, Brousseau M, Chertkow H, Phillips N, Nasreddine ZS. Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease. J Am Geriatr Soc 2014;62:679-684.
  5. Kim H, Yu KH, Lee BC, Kim BC, Kang Y. Validity of the Montreal Cognitive Assessment (MoCA) index scores: a comparison with the cognitive domain scores of the Seoul Neuropsychological Screening Battery (SNSB). Dement Neurocogn Disord 2021;20:28-37.
  6. Wittich W, Phillips N, Nasreddine ZS, Chertkow H. Sensitivity and specificity of the Montreal Cognitive Assessment modified for individuals who are visually impaired. J Vis Impair Blind 2010;104:360-368.
  7. Amitrano NR, Lord AR, Gonzalez DA. Montreal Cognitive Assessment's auditory items (MoCA-22): normative data and reliable change indices. Appl Neuropsychol Adult 2024;38:1-8.
  8. Lord AR, Amitrano NR, Gonzalez DA. Reliability and validity of the Montreal Cognitive Assessment's auditory items (MoCA-22). Clin Neuropsychol 2024;38:783-798.
  9. Yip CC, Wong WW, Cheng CP, Chiu AT. The Hong Kong version of Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI): proposed cut-off and cognitive functioning survey of visually impaired elderly in residential homes. PLoS One 2024;19:e0305426.
  10. Parks AC, Davis J, Spresser CD, Stroescu I, Ecklund-Johnson E. Validity of in-home teleneuropsychological testing in the wake of COVID-19. Arch Clin Neuropsychol 2021;36:887-896.
  11. Sumpter R, Camsey E, Meldrum S, Alford M, Campbell I, Bois C, et al. Remote neuropsychological assessment: acceptability and feasibility of direct-to-home teleneuropsychology methodology during the COVID-19 pandemic. Clin Neuropsychol 2023;37:432-447.
  12. Marra DE, Hamlet KM, Bauer RM, Bowers D. Validity of teleneuropsychology for older adults in response to COVID-19: a systematic and critical review. Clin Neuropsychol 2020;34:1411-1452.
  13. Phillips NA, Chertkow H, Pichora-Fuller MK, Wittich W. Special issues on using the Montreal Cognitive Assessment for telemedicine assessment during COVID-19. J Am Geriatr Soc 2020;68:942-944.
  14. Frontera JA, Yang D, Lewis A, Patel P, Medicherla C, Arena V, et al. A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications. J Neurol Sci 2021;426:117486.
  15. Valdes E, Fuchs B, Morrison C, Charvet L, Lewis A, Thawani S, et al. Demographic and social determinants of cognitive dysfunction following hospitalization for COVID-19. J Neurol Sci 2022;438:120146.
  16. Pendlebury ST, Welch SJ, Cuthbertson FC, Mariz J, Mehta Z, Rothwell PM. Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery. Stroke 2013;44:227-229.
  17. Chapman JE, Cadilhac DA, Gardner B, Ponsford J, Bhalla R, Stolwyk RJ. Comparing face-to-face and videoconference completion of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke. J Telemed Telecare 2021;27:484-492.
  18. Lai Y, Zhao M, Jiang C, Du X, Wang Z, Zhang J, et al. Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation. Front Cardiovasc Med 2022;9:896846.
  19. Katz MJ, Wang C, Nester CO, Derby CA, Zimmerman ME, Lipton RB, et al. T-MoCA: a valid phone screen for cognitive impairment in diverse community samples. Alzheimers Dement (Amst) 2021;13:e12144.
  20. Morgenstern LB, Briceno EM, Mehdipanah R, Chang W, Lewandowski-Romps L, Gonzales XF, et al. A community-based study of dementia in Mexican American and non-Hispanic White individuals. J Alzheimers Dis 2024;97:649-658.
  21. Amos JG, Zheng L, Eramudugolla R, Parekh D, Huque MH, Delbaere K, et al. MyCOACH (COnnected Advice for Cognitive Health): a digitally delivered multidomain intervention for cognitive decline and risk of dementia in adults with mild cognitive impairment or subjective cognitive decline-study protocol for a randomised controlled trial. BMJ Open 2023;13:e075015.
  22. Cooper L, Krishnan S, Javedan H, Bader AM, Tulabaev S. A proposal for virtual, telephone-based preoperative cognitive assessment in older adults undergoing elective surgery. Perioper Med (Lond) 2022;11:41.
  23. Binoy S, Lithwick Algon A, Ben Adiva Y, Montaser-Kouhsari L, Saban W. Online cognitive testing in Parkinson's disease: advantages and challenges. Front Neurol 2024;15:1363513.
  24. Dodge HH, Yu K, Wu CY, Pruitt PJ, Asgari M, Kaye JA, et al. Internet-Based Conversational Engagement Randomized Controlled Clinical Trial (I-CONECT) among socially isolated adults 75+ years old with normal cognition or mild cognitive impairment: topline results. Gerontologist 2024;64:gnad147.
  25. Kim H, Yang S, Park J, Kim BC, Yu KH, Kang Y. Effect of education on discriminability of Montreal Cognitive Assessment compared to Mini-Mental State Examination. Dement Neurocogn Disord 2023;22:69-77.
  26. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183-194.
  27. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington, D.C.: American Psychiatric Pub, 2013.
  28. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412-2414.
  29. Kang Y, Park JS, Yu KH, Lee BC. A reliability, validity, and normative study of the Korean-Montreal Cognitive Assessment (K-MoCA) as an instrument for screening of vascular cognitive impairment. Korean J Clin Psychol 2009;28:549-562.
  30. Kang Y. A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly. Korean J Psychol Gen 2006;25:1-12.
  31. Kang Y, Jahng S, Na DL. Seoul Neuropsychological Screening Battery. 2nd ed. Incheon: Human Brain Research and Consulting, 2012.
  32. Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983;148:839-843.
  33. Folstein SE, White T, Messer MA. MMSE-2 User's Manual. Lutz: Psychological Assessment Resources, 2010.
  34. Vadikolias K, Tsiakiri-Vatamidis A, Tripsianis G, Tsivgoulis G, Ioannidis P, Serdari A, et al. Mild cognitive impairment: effect of education on the verbal and nonverbal tasks performance decline. Brain Behav 2012;2:620-627.