Nazem Sarra, Siderowf Andrew D, Duda John E, Have Tom Ten, Colcher Amy, Horn Stacy S, Moberg Paul J, Wilkinson Jayne R, Hurtig Howard I, Stern Matthew B, Weintraub Daniel
Department of Psychiatry, University of Pennsyvania, Philadelphia, USA.
J Am Geriatr Soc. 2009 Feb;57(2):304-8. doi: 10.1111/j.1532-5415.2008.02096.x. Epub 2008 Dec 10.
To examine Montreal Cognitive Assessment (MoCA) performance in patients with Parkinson's disease (PD) with "normal" global cognition according to Mini-Mental State Examination (MMSE) score.
A cross-sectional comparison of the MoCA and the MMSE.
Two movement disorders centers at the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center.
A convenience sample of 131 patients with idiopathic PD who were screened for cognitive and psychiatric complications.
Subjects were administered the MoCA and MMSE, and only subjects defined as having a normal age- and education-adjusted MMSE score were included in the analyses (N=100). As previously recommended in patients without PD, a MoCA score less than 26 was used to indicate the presence of at least mild cognitive impairment (MCI).
Mean MMSE and MoCA scores+/-standard deviation were 28.8+/-1.1 and 24.9+/-3.1, respectively. More than half (52.0%) of subjects with normal MMSE scores had cognitive impairment according to their MoCA score. Impairments were seen in numerous cognitive domains, including memory, visuospatial and executive abilities, attention, and language. Predictors of cognitive impairment on the MoCA using univariate analyses were male sex, older age, lower educational level, and greater disease severity; older age was the only predictor in a multivariate model.
Approximately half of patients with PD with a normal MMSE score have cognitive impairment based on the recommended MoCA cutoff score. These results suggest that MCI is common in PD and that the MoCA is a more sensitive instrument than the MMSE for its detection.
根据简易精神状态检查表（MMSE）评分，研究帕金森病（PD）患者中具有“正常”整体认知功能者的蒙特利尔认知评估量表（MoCA）表现。
MoCA与MMSE的横断面比较。
宾夕法尼亚大学和费城退伍军人事务医疗中心的两个运动障碍中心。
选取131例特发性PD患者的便利样本，对其进行认知和精神并发症筛查。
对受试者进行MoCA和MMSE测试，分析中仅纳入年龄和教育程度校正后MMSE评分正常的受试者（N = 100）。如先前针对非PD患者所建议的，MoCA评分低于26分用于表明至少存在轻度认知障碍（MCI）。
MMSE和MoCA评分的均值±标准差分别为28.8±1.1和24.9±3.1。MMSE评分正常的受试者中，超过一半（52.0%）根据其MoCA评分存在认知障碍。在多个认知领域均可见障碍，包括记忆、视觉空间和执行能力、注意力及语言。单因素分析中，MoCA认知障碍的预测因素为男性、年龄较大、教育水平较低及疾病严重程度较高；多因素模型中，年龄较大是唯一的预测因素。
基于推荐的MoCA临界值评分，约一半MMSE评分正常的PD患者存在认知障碍。这些结果表明，MCI在PD中很常见，且MoCA在检测MCI方面比MMSE更敏感。
