title: Utility of the Montreal Cognitive Assessment (MoCA) and its subset in HIV-associated neurocognitive disorder (HAND) screening.
abstract: OBJECTIVE
  The Montreal Cognitive Assessment (MoCA) is a useful screening tool for mild cognitive impairment. We aimed to know whether the full MoCA and subsets of the full test are effective for detecting HIV-associated neurocognitive disorder (HAND).
  
  
  METHODS
  We examined the socio-demographic, clinical, functional, and neuropsychological levels of 194 HIV-infected patients. We compared total scores and scores from each cognitive domain of MoCA between patients with and without HAND. We also examined the utility of subsets of the full test using a few selective domains. The diagnostic accuracies of MoCA and subset composition were evaluated.
  
  
  RESULTS
  The total scores of MoCA (P<0.001) and scores from Trail Making Test-B (P=0.020), attention domain (P=0.005), and immediate (P=0.003) and delayed recall (P=0.002) differed between patients with and without HAND. A subset composed of Trail Making Test-B, rescored serial subtraction, and immediate/delayed recall showed a 69.2% accuracy.
  
  
  CONCLUSIONS
  Our results suggest that the MoCA and its subsets alone are not sufficient in screening for HAND. Further studies will be needed to develop a simpler and easier screening tool for HAND based on this study.
authors.affiliation: Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: woojay00@naver.com.
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: smileboy9@yuhs.ac.
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Ku
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: yjoonlee@yuhs.ac.
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: comebacktosea@yuhs.ac.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: puppybin8171@yuhs.ac.
authors.forename: Sun Bean
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: ahnhyeone@yuhs.ac.
authors.forename: Hye-Won
authors.initials: HW
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea. Electronic address: resina78@naver.com.
authors.forename: Kyung-Wook
authors.initials: KW
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. Electronic address: infection@korea.ac.kr.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. Electronic address: heejinmd@korea.ac.kr.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. Electronic address: wjkim@korea.ac.kr.
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: jmkim@yuhs.ac.
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: keen@yuhs.ac.
authors.forename: Kee
authors.initials: K
authors.lastname: Namkoong
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: seran@yuhs.ac.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: kimeosu@yuhs.ac.
authors.forename: Eosu
authors.initials: E
authors.lastname: Kim
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000523:psychology*; D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000523:psychology; D006801:Humans; D007807:Language Tests; D008297:Male; D008403:Mass Screening; D008570:Memory, Short-Term; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D014145:Trail Making Test
keywords: HIV-associated neurocognitive disorder; Montreal Cognitive Assessment; Neuropsychological test; Screening method