Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.
Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
Arch Clin Neuropsychol. 2022 Jan 17;37(1):117-124. doi: 10.1093/arclin/acab029.
Cardiovascular diseases involve a continuum starting with risk factors, which can progress to coronary heart disease and eventually, to heart failure. Cognitive impairment (CI) is observed as early as cardiovascular risk factors, and in up to 50% of patients with heart failure. Because CI in cardiovascular disease is linked to poorer clinical outcomes, early detection is essential. The Montreal Cognitive Assessment (MoCA) is a screening tool widely used in clinical setting. To date, little is known about MoCA scores along the cardiovascular disease continuum.
This study compared performances of different cardiovascular disease profiles on the MoCA and its subscores.
Eighty participants (>50 years) from two studies conducted at the Montreal Heart Institute were separated into four groups: low cardiovascular risk factors (<2), high cardiovascular risk factors (>2), coronary heart disease, and stable heart failure. ANCOVAs were performed on the total score and on subscores, with sex, age, and education as covariates.
Group differences were observed on the MoCA total score (heart failure < low cardiovascular risk), verbal fluency (heart failure < low cardiovascular risk), memory (coronary heart disease < low cardiovascular risk), and orientation (coronary heart disease < low and high cardiovascular risk) subscores.
Results suggest that the MoCA, particularly verbal fluency and memory subscores, can detect cognitive changes in later stages of the cardiovascular disease continuum, such as heart failure. Detecting cognitive changes earlier on the cardiovascular disease continuum may require more in depth neuropsychological assessments.
目的:本研究比较了不同心血管疾病谱在蒙特利尔认知评估(MoCA)及其子项上的表现。
方法:来自蒙特利尔心脏研究所两项研究的 80 名(>50 岁)参与者被分为四组:低心血管危险因素(<2)、高心血管危险因素(>2)、冠心病和稳定心力衰竭。总评分和子项评分均进行协方差分析,协变量为性别、年龄和教育程度。
结果:MoCA 总分(心力衰竭<低心血管危险因素)、词语流畅性(心力衰竭<低心血管危险因素)、记忆(冠心病<低心血管危险因素)和定向(冠心病<低和高心血管危险因素)子项上存在组间差异。
结论:结果表明,MoCA,特别是词语流畅性和记忆子项,可以检测到心血管疾病连续体后期(如心力衰竭)的认知变化。更早地检测心血管疾病连续体上的认知变化可能需要更深入的神经心理学评估。