TY - JOUR
T1 - The MoCA and MMSE as screeners for cognitive impairment in a heart failure population
T2 - A study with comprehensive neuropsychological testing
AU - Hawkins, Misty A.W.
AU - Gathright, Emily C.
AU - Gunstad, John
AU - Dolansky, Mary A.
AU - Redle, Joseph D.
AU - Josephson, Richard
AU - Moore, Shirley M.
AU - Hughes, Joel W.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
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.
UR - http://www.scopus.com/inward/record.url?scp=84908504968&partnerID=8YFLogxK
U2 - 10.1016/j.hrtlng.2014.05.011
DO - 10.1016/j.hrtlng.2014.05.011
M3 - Article
C2 - 25035250
AN - SCOPUS:84908504968
SN - 0147-9563
VL - 43
SP - 462
EP - 468
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
IS - 5
ER -