title: The Montreal Cognitive Assessment (MoCA) in geriatric rehabilitation: psychometric properties and association with rehabilitation outcomes.
abstract: BACKGROUND
  Cognitive status has been reported to be an important predictor of rehabilitation outcome. The Montreal Cognitive Assessment (MoCA) was designed to overcome some of the limitations of established cognitive screening tools such as the Mini-Mental State Examination (MMSE). The purpose of this study is to evaluate the psychometric characteristics of the MoCA as a screening tool in a geriatric rehabilitation program and its ability to predict rehabilitation outcome.
  
  
  METHODS
  Forty-seven geriatric rehabilitation program patients participated in the study. Assessments of each patient's functional (Functional Independence Measure) and cognitive status (MMSE and MoCA) were performed. Information on discharge destinations were obtained and rehabilitation efficacy and efficiency scores were calculated.
  
  
  RESULTS
  Significant correlations were found between the MoCA and other cognitive status measures. Cognitive status at admission and successful rehabilitation were also associated. Defining rehabilitation success on the basis of relative functional efficacy (an indicator that includes the patient's potential for improvement), the sensitivity and specificity of the MoCA were 80% and 30% respectively. The attention subscale of the MoCA was also uniquely predictive of rehabilitation success. The attention subscale (cutoff 5/6) of the MoCA had a sensitivity of 40% and specificity of 90%, as did the MMSE.
  
  
  CONCLUSIONS
  As a cognitive screening tool, the MoCA appears to have acceptable psychometric properties. Results suggest that the MoCA can have a considerable advantage over the MMSE in sensitivity and equivalence in specificity using both total and attention scale scores. The MoCA may be a more useful measure for detecting cognitive impairment and predicting rehabilitation outcome in this population.
authors.affiliation: Memory Disorder Clinic, Bruyère Continuing Care, Ottawa, Ontario, Canada. LSweet@bruyere.org
authors.forename: Lisa
authors.initials: L
authors.lastname: Sweet
authors.forename: Mike
authors.initials: M
authors.lastname: Van Adel
authors.forename: Valerie
authors.initials: V
authors.lastname: Metcalf
authors.forename: Lisa
authors.initials: L
authors.lastname: Wright
authors.forename: Anne
authors.initials: A
authors.lastname: Harley
authors.forename: René
authors.initials: R
authors.lastname: Leiva
authors.forename: Vanessa
authors.initials: V
authors.lastname: Taler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003072:Cognition Disorders / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D005853:Geriatrics / Q000379:methods*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome