O'Caoimh Rónán, Foley Mary J, Timmons Suzanne, Molloy D William
Department of Geriatric and Stroke Medicine, Mercy University Hospital, Grenville Place, Cork, Ireland.
Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, Cork, Ireland.
J Alzheimers Dis Rep. 2024 Jun 21;8(1):971-980. doi: 10.3233/ADR-230207. eCollection 2024.
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.
To compare the MoCA and Quick Mild Cognitive Impairment (Q screen in this population.
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).
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.
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.
蒙特利尔认知评估量表（MoCA）被运动障碍协会推荐用于帕金森病（PD）和路易体痴呆等运动障碍的认知测试。很少有研究比较这些临床症状重叠的疾病中的认知筛查工具。
比较MoCA和简易精神状态检查表（Q）在该人群中的表现。
在大学医院的记忆和运动障碍门诊就诊的患者接受了MoCA和Q测试，并将诊断准确性与受试者工作特征曲线（AUC）下的面积进行比较。使用统一帕金森病评定量表（UPDRS）评估运动障碍的持续时间和严重程度。
总共进行了133次评估，中位年龄为74±5岁。中位受教育年限为11±4年，65%为男性。UPDRS总分中位数为37±26。Q测试中位数为51±27，MoCA中位数为19±10。主观症状正常、轻度认知障碍（MCI）和痴呆患者的测试分数存在统计学显著差异（<0.001）。与MoCA相比，Q测试在区分正常认知与MCI方面具有显著更高的准确性（AUC分别为0.90和0.72，P=0.01）。两种工具在识别认知障碍和区分MCI与痴呆方面具有相似的准确性。Q测试和MoCA的中位施测时间分别为5.19分钟和9.24分钟（P<0.001）。
MoCA和Q测试在有认知症状的运动障碍人群中均具有良好到优异的准确性。Q测试对早期症状患者的准确性显著更高，且施测时间更短。
