title: The Montreal Cognitive Assessment (MoCA) as a screening test for cognitive dysfunction in multiple sclerosis.
abstract: This study investigates the utility of the Portuguese version of Montreal Cognitive Assessment (MoCA) as a screening-method for identifying cognitive dysfunction (CD) in multiple sclerosis (MS). The 118 participants with comprehensive neuropsychological assessment were divided into two subgroups: (I) MS group (n = 59) and (II) control group (n = 59). The MS patients were classified as cognitively intact (n = 26) or impaired (n = 33, 56%). The results indicated that the MoCA is a psychometrically valid instrument in assessment of MS patients. The Multiple Linear Regression analyses highlighted the significant influence of Modified Fatigue Impact Scale and Irregular Word Reading Test on MoCA performance. The MoCA total score showed a good discriminative capacity between cognitively impaired and cognitively intact subjects. In addition, there were significant differences in MoCA cognitive domain scores between groups. The MoCA total score cut-off point for identifying CD in MS patients was a score below 26 points (AUC = 0.837, CI = 0.736-0.937). A proposed EM-MoCA-Subscore for identifying the MS-related cognitive impairment (max. score = 19 points, cut-off <17 points, AUC = 0.871, CI = 0.784-0.958), can reduce administration time for cognitive screening in clinical settings. The MoCA is a useful and sensitive instrument to identify the MS-related cognitive impairment.
authors: a Centre for Neuroscience and Cell Biology (CNC) , University of Coimbra , Coimbra , Portugal.|b Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC) , University of Coimbra , Coimbra , Portugal.|c PsyAssessmentLab, Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.
authors: Sandra
authors: S
authors: Freitas
authors: d Neurology Department , Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal.
authors: Sónia
authors: S
authors: Batista
authors: e Faculty of Medicine , University of Coimbra , Coimbra , Portugal.
authors: Ana Cristina
authors: AC
authors: Afonso
authors: b Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC) , University of Coimbra , Coimbra , Portugal.|c PsyAssessmentLab, Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.
authors: Mário R
authors: http://orcid.org/0000-0002-1311-1338
authors: MR
authors: Simões
authors: d Neurology Department , Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal.|e Faculty of Medicine , University of Coimbra , Coimbra , Portugal.
authors: Lívia
authors: L
authors: de Sousa
authors: d Neurology Department , Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal.|e Faculty of Medicine , University of Coimbra , Coimbra , Portugal.
authors: Luís
authors: L
authors: Cunha
authors: a Centre for Neuroscience and Cell Biology (CNC) , University of Coimbra , Coimbra , Portugal.|d Neurology Department , Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal.|e Faculty of Medicine , University of Coimbra , Coimbra , Portugal.
authors: Isabel
authors: I
authors: Santana
mesh_terms: D000293:Adolescent; D000328:Adult; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D000073216:Mental Status and Dementia Tests; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology; D011594:Psychometrics; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Cognitive impairment; diagnostic accuracy; early diagnosis; multiple sclerosis; neuropsychological tests