Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong SAR, China.
PLoS One. 2018 May 23;13(5):e0196344. doi: 10.1371/journal.pone.0196344. eCollection 2018.
Repeated testing using the Montreal Cognitive Assessment (MoCA) increases risks for practice effects which may bias measurements of cognitive change. The objective of this study is to develop two alternate versions of the MoCA (Hong Kong version; HK-MoCA) and to investigate the validity and reliability of the alternate versions in patients with DSM-5 Mild Neurocognitive Disorder (Mild NCD) and cognitively healthy controls.
Concurrent validity and inter-scale agreement were examined by Pearson correlation of the total scores between the original and alternate versions and the Bland-Altman Method. Criterion validity of the two alternate versions in differentiating patients with Mild NCD was tested using receiver operating characteristic curve (ROC) analysis. One-month test-retest and inter-rater reliability were examined in 20 participants. Internal consistency of the alternate versions was measured by the Cronbach's α.
30 controls (age 73.4 [4.5] years, 60% female) and 30 patients (age 75.4 [5.5] years, 73% female) with Mild NCD were recruited. Both alternate versions significantly correlated with the original version (r = 0.79-0.87, p<0.001). Mean differences of 0.17 and -0.40 points were found between the total scores of the alternate with the original versions with a consistent level of agreement observed throughout the range of cognitive abilities. Both alternate versions significantly differentiated patients with Mild NCD from healthy controls (area under ROC 0.922 and 0.724, p<0.001) and showed good one-month test-retest reliability (intra-class correlation [ICC] = 0.92 and 0.82) and inter-rater reliability (ICC = 0.99 and 0.87) and high internal consistency (Cronbach α = 0.79 and 0.75).
The two alternate versions of the HK-MoCA are useful for Mild NCD screening.
使用蒙特利尔认知评估（MoCA）进行重复测试会增加出现练习效应的风险，这可能会影响认知变化的测量结果。本研究的目的是开发 MoCA 的两种替代版本（香港版本；HK-MoCA），并在符合 DSM-5 轻度神经认知障碍（Mild NCD）和认知健康对照者标准的患者中研究替代版本的有效性和可靠性。
通过原始版本和替代版本总分之间的 Pearson 相关性和 Bland-Altman 方法，考察了两种替代版本的同时效性和量表内一致性。使用受试者工作特征曲线（ROC）分析，检验了两种替代版本在区分轻度 NCD 患者方面的判别有效性。对 20 名参与者进行了一个月的重测信度和评分者间信度检验。采用 Cronbach's α 测量替代版本的内部一致性。
共纳入 30 名对照者（年龄 73.4[4.5]岁，60%为女性）和 30 名轻度 NCD 患者（年龄 75.4[5.5]岁，73%为女性）。两种替代版本与原始版本显著相关（r = 0.79-0.87，p<0.001）。替代版本与原始版本总分之间的差值分别为 0.17 和-0.40 分，在整个认知能力范围内均显示出一致的一致性水平。两种替代版本均能显著区分轻度 NCD 患者和健康对照者（ROC 曲线下面积为 0.922 和 0.724，p<0.001），并具有良好的一个月重测信度（组内相关系数 [ICC] = 0.92 和 0.82）和评分者间信度（ICC = 0.99 和 0.87），内部一致性较高（Cronbach α = 0.79 和 0.75）。
HK-MoCA 的两种替代版本可用于轻度 NCD 筛查。
