BACKGROUND

The Montreal Cognitive Assessment (MoCA) is recommended by the Movement Disorder Society for cognitive testing in movement disorders including Parkinson's disease (PD) and lewy body dementia. Few studies have compared cognitive screening instruments in these diseases, which overlap clinically.

OBJECTIVE

To compare the MoCA and Quick Mild Cognitive Impairment (Q screen in this population.

METHODS

Patients attending memory and movement disorder clinics associated with a university hospital had the MoCA and Q screen performed and diagnostic accuracy compared with the area under the receiver operating characteristic curve (AUC). Duration and severity of movement disorders was assessed using the Unified PD Rating Scale (UPDRS).

RESULTS

In total, 133 assessments were available, median age 74±5. Median education was 11±4 years and 65% were male. Median total UPDRS score was 37±26. Median Q screen was 51±27, median MoCA was 19±10. There were statistically significant differences in test scores between those with subjective symptoms but normal cognition, mild cognitive impairment (MCI) and dementia ( < 0.001). The Q screen had significantly greater accuracy differentiating normal cognition from MCI versus the MoCA (AUC 0.90 versus 0.72,  = 0.01). Both instruments had similar accuracy in identifying cognitive impairment and separating MCI from dementia. The median administration time for the Q screen and MoCA were 5.19 and 9.24 minutes ( < 0.001), respectively.

CONCLUSIONS

Both the MoCA and Q screen have good to excellent accuracy in a population with movement disorders experiencing cognitive symptoms. The Q screen was significantly more accurate for those with early symptoms and had a shorter administration time.