The MoCA and MMSE as screeners for cognitive impairment in a heart failure population: A study with comprehensive neuropsychological testing

Misty A.W. Hawkins, Emily C. Gathright, John Gunstad, Mary A. Dolansky, Joseph D. Redle, Richard Josephson, Shirley M. Moore, Joel W. Hughes

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: To examine the ability of the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to detect cognitive impairment in persons with heart failure (HF). Background: Although the MMSE and MoCA are commonly used screeners in HF, no research team has validated their performance against neuropsychological testing. Methods: Participants were 106 patients with HF (49.1% male, 68.13±9.82 years) who completed the MoCA, MMSE, and a full neuropsychological battery. Sensitivity and specificity were examined. Discriminant function analyses tested whether the screeners correctly detected cognitive impairment. Results: A MoCA score <25 and MMSE score of <28 yielded optimal sensitivity/specificity (.64/.66 and .70/.66, respectively). The MoCA correctly classified 65% of patients, Wilk's lambda=.91, χ2(1)=9.89, p<.01, and the MMSE correctly classified 68%, Wilk's lambda=.87, χ2(1)=14.26, p<.001. Conclusions: In HF, both the MoCA and MMSE are useful in identifying the majority of patients with and without cognitive impairment. Both tests misclassified approximately one-third of patients, so continued monitoring and evaluation of patients is needed in conjunction with screening.

Original languageEnglish
Pages (from-to)462-468
Number of pages7
JournalHeart and Lung: Journal of Acute and Critical Care
Volume43
Issue number5
DOIs
StatePublished - 1 Jan 2014
Externally publishedYes

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Heart Failure
Population
Sensitivity and Specificity
Aptitude
Physiologic Monitoring
Discriminant Analysis
Cognitive Dysfunction
Research

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Hawkins, Misty A.W. ; Gathright, Emily C. ; Gunstad, John ; Dolansky, Mary A. ; Redle, Joseph D. ; Josephson, Richard ; Moore, Shirley M. ; Hughes, Joel W. / The MoCA and MMSE as screeners for cognitive impairment in a heart failure population : A study with comprehensive neuropsychological testing. In: Heart and Lung: Journal of Acute and Critical Care. 2014 ; Vol. 43, No. 5. pp. 462-468.
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The MoCA and MMSE as screeners for cognitive impairment in a heart failure population : A study with comprehensive neuropsychological testing. / Hawkins, Misty A.W.; Gathright, Emily C.; Gunstad, John; Dolansky, Mary A.; Redle, Joseph D.; Josephson, Richard; Moore, Shirley M.; Hughes, Joel W.

In: Heart and Lung: Journal of Acute and Critical Care, Vol. 43, No. 5, 01.01.2014, p. 462-468.

Research output: Contribution to journalArticle

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AB - Objective: To examine the ability of the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to detect cognitive impairment in persons with heart failure (HF). Background: Although the MMSE and MoCA are commonly used screeners in HF, no research team has validated their performance against neuropsychological testing. Methods: Participants were 106 patients with HF (49.1% male, 68.13±9.82 years) who completed the MoCA, MMSE, and a full neuropsychological battery. Sensitivity and specificity were examined. Discriminant function analyses tested whether the screeners correctly detected cognitive impairment. Results: A MoCA score <25 and MMSE score of <28 yielded optimal sensitivity/specificity (.64/.66 and .70/.66, respectively). The MoCA correctly classified 65% of patients, Wilk's lambda=.91, χ2(1)=9.89, p<.01, and the MMSE correctly classified 68%, Wilk's lambda=.87, χ2(1)=14.26, p<.001. Conclusions: In HF, both the MoCA and MMSE are useful in identifying the majority of patients with and without cognitive impairment. Both tests misclassified approximately one-third of patients, so continued monitoring and evaluation of patients is needed in conjunction with screening.

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