title: Montreal Cognitive Assessment (MoCA) screening mild cognitive impairment in patients with chronic kidney disease (CKD) pre-dialysis.
abstract: BACKGROUND
  Individuals with chronic kidney disease (CKD) are at higher risk of developing cognitive impairment (CI), initially mild (MCI), potentially identifiable, but still poorly diagnosed and treated. The Montreal Cognitive Assessment (MoCA) has been indicated for MCI screening in CKD.
  
  
  OBJECTIVE
  To assess MCI in patients with CKD not yet on dialysis.
  
  
  METHODS
  Study conducted in 72 non-elderly subjects with pre-dialysis CKD. The neuropsychological assessment included: The global cognitive assessment test MoCA; the clock drawing (CD); the digit span forward (DSF) and reverse (DSR); phonemic verbal (VF) fluency (FAS) and semantics (animals); the fist-edge-palm (FEP); and the memory 10 pictures.
  
  
  RESULTS
  The average age of the participants was 56.74 ± 7.63 years, with predominance of male sex (55.6%), mainly with ≥ 4 years of education (84.3%), with CKD cathegories 1, 2 and 3a and 3b (67.6%), hypertension (93.1%) and diabetes mellitus (52.1%). MCI (MoCA ≤ 24) was observed in 73.6% of the patients. We did not find association among MCI with demographic and clinical variables, but a tendency to association with age (p = 0.07), educational level (p= 0.06) and diabetes (0.06). The executive function tests CD, DS-reverse and FEP, individually were able to identify CI with good sensibility and negative predictive value compared to MoCA and together, showed the same capability to identify MCI when compared to MoCA.
  
  
  CONCLUSIONS
  The MCI is common in non-elderly patients with CKD not yet on dialysis. Together, the CD, DSR and FEP showed similar performance in identify MCI in this population when compared to MoCA, suggesting impairment of executive functions.
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil.
authors.forename: Marilise de Andrade
authors.initials: Mde A
authors.lastname: Paraizo
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil.
authors.forename: Ana Laura Maciel
authors.initials: AL
authors.lastname: Almeida
authors.affiliation: Universidade Federal de São Paulo, Brazil.
authors.forename: Leopoldo Antônio
authors.initials: LA
authors.lastname: Pires
authors.affiliation: Fundação Imepen-Instituto Mineiro de Estudo Pesquisa em Nefrologia, Brazil.
authors.forename: Renata Silva Almeida
authors.initials: RS
authors.lastname: Abrita
authors.affiliation: Fundação Imepen-Instituto Mineiro de Estudo Pesquisa em Nefrologia, Brazil.
authors.forename: Mary Hellen Teixeira
authors.initials: MH
authors.lastname: Crivellari
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil.
authors.forename: Beatriz Dos Santos
authors.initials: Bdos S
authors.lastname: Pereira
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil.
authors.forename: Natália Maria da Silva
authors.initials: NM
authors.lastname: Fernandes
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil.
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
mesh_terms: D000328:Adult; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications*