Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy,
Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy.
Eur Neurol. 2024;87(2):79-83. doi: 10.1159/000538828. Epub 2024 Apr 20.
The present study aimed at testing the longitudinal feasibility of the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented amyotrophic lateral sclerosis (ALS) patients.
N = 39 non-demented ALS patients were followed-up at a 5-to-10-month interval (M = 6.8; SD = 1.4) with the MoCA and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Practice effects, test-retest reliability, and predictive validity (against follow-up ECAS scores) were assessed. Reliable change indices (RCIs) were derived via a regression-based approach by accounting for retest interval and baseline confounders (i.e., demographics, disease duration, and severity and progression rate).
At retest, 100% and 69.2% of patients completed the ECAS and the MoCA, respectively. Patients who could not complete the MoCA showed a slightly more severe and fast-progressing disease. The MoCA was not subject to practice effects (t[32] = -0.80; p = 0.429) and was reliable at retest (intra-class correlation = 0.82). Moreover, baseline MoCA scores predicted the ECAS at retest. RCIs were successfully derived - with baseline MoCA scores being the only significant predictor of retest performances (ps < 0.001).
As long as motor disabilities do not undermine its applicability, the MoCA appears to be longitudinally feasible at a 5-to-10-month interval in non-demented ALS patients. However, ALS-specific screeners - such as the ECAS - should be preferred whenever possible.
本研究旨在测试蒙特利尔认知评估（MoCA）在意大利非痴呆型肌萎缩侧索硬化症（ALS）患者队列中的纵向可行性。
N = 39 名非痴呆型 ALS 患者以 5 至 10 个月的间隔（M = 6.8；SD = 1.4）接受 MoCA 和爱丁堡认知和行为 ALS 筛查（ECAS）的随访。评估了练习效应、测试-重测信度和预测效度（与后续 ECAS 分数相对应）。通过基于回归的方法，考虑重测间隔和基线混杂因素（即人口统计学、疾病持续时间以及严重程度和进展率）得出可靠变化指数（RCIs）。
在重测时，分别有 100%和 69.2%的患者完成了 ECAS 和 MoCA。无法完成 MoCA 的患者表现出稍微更严重和快速进展的疾病。MoCA 不受练习效应影响（t[32] = -0.80；p = 0.429），且在重测时具有可靠性（组内相关系数= 0.82）。此外，基线 MoCA 分数可预测重测时的 ECAS。成功推导出 RCIs - 只有基线 MoCA 分数是重测表现的唯一显著预测因子（ps < 0.001）。
只要运动障碍不影响其适用性，MoCA 在非痴呆型 ALS 患者中以 5 至 10 个月的间隔进行纵向评估是可行的。但是，只要可能，应优先使用针对 ALS 的筛查工具，例如 ECAS。
