School of Medical and Health Sciences, Tung Wah College, Mongkok, Kowloon, Hong Kong, SAR, China.
Department of Chinese and Bilingual Studies, Faculty of Humanities, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong, SAR, China.
PLoS One. 2024 Jun 26;19(6):e0305426. doi: 10.1371/journal.pone.0305426. eCollection 2024.
Visual impairment has been strongly associated with the incidence of dementia. Appropriate cognitive screening for the elderly with visual impairment is crucial for early identification of dementia and its management. Due to challenges in processing visually presented stimuli among participants, the cut-off score of the Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI), also known as MoCA-BLIND or MoCA-22, was unknown. Besides, the cognitive status of elderly with visual impairment residing in care homes is rarely investigated. The current study aimed to 1) establish the cut-off score for HKMoCA-VI and 2) examine the general cognitive functioning of elderly with visual impairment living in residential homes in Hong Kong in terms of MoCA-VI percentile scores.
HKMoCA-VI and the Cantonese version of the Mini-Mental State Examination (CMMSE) were administered to 123 visually impaired elderly residents in care homes in Hong Kong. Percentile scores of HKMoCA-VI by age and education level were determined, and the concurrent validity, sensitivity, and specificity of HKMoCA-VI were assessed.
A cut-off score 12 was suggested for HKMoCA-VI, which yielded a sensitivity and specificity of 89.29% and 83.58%, respectively. Moreover, it strongly correlated with CMMSE, indicating satisfactory concurrent validity.
HKMoCA-VI is suggested to be a viable cognitive screening tool for elderly individuals with visual impairment in residential homes. Further modifications to enhance the sensitivity and specificity of the measure are proposed.
视力障碍与痴呆症的发病率密切相关。对视力受损的老年人进行适当的认知筛查对于早期发现痴呆症及其管理至关重要。由于参与者在处理视觉呈现刺激方面存在挑战，香港蒙特利尔认知评估（视障版）（HKMoCA-VI）的截止分数，也称为 MoCA-BLIND 或 MoCA-22，尚不清楚。此外，视力受损的老年人在养老院的认知状况很少被调查。本研究旨在：1）建立 HKMoCA-VI 的截止分数；2）根据 HKMoCA-VI 的百分位数分数，检查香港养老院中视力受损的老年人的一般认知功能。
对香港养老院的 123 名视力受损的老年人进行了 HKMoCA-VI 和粤语版简易精神状态检查（CMMSE）的测试。确定了 HKMoCA-VI 按年龄和教育程度划分的百分位数分数，并评估了 HKMoCA-VI 的同时效度、敏感性和特异性。
建议使用 12 作为 HKMoCA-VI 的截止分数，其敏感性和特异性分别为 89.29%和 83.58%。此外，它与 CMMSE 强烈相关，表明具有令人满意的同时效度。
HKMoCA-VI 是一种可行的用于养老院视力受损老年人的认知筛查工具。建议进一步修改该措施以提高其敏感性和特异性。
