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"J Am Geriatr Soc" Category Publications:

Title Authors PubMed ID
1 Clinical judgement is paramount when performing cognitive screening during COVID-19. Phillips NA, Andrews M, Chertkow H, Pichora-Fuller MK, Rockwood K, Wittich W 32396983
PSYCHOLOGY
2 Special issues on using the MoCA for remote assessment during COVID-19 2. Phillips NA, Chertkow H, Pichora-Fuller MK, Wittich W 32253754
PSYCHOLOGY
3 The Montreal Cognitive Assessment After Omission of Hearing-Dependent Subtests: Psychometrics and Clinical Recommendations Al-Yawer F; Pichora-Fuller MK; Phillips NA; 31018015
PSYCHOLOGY
4 Drivers with Amnestic Mild Cognitive Impairment Can Benefit from a Multiple-Session Driving Simulator Automated Training Program. Teasdale N, Simoneau M, Hudon L, Moszkowicz T, Laurendeau D, Germain Robitaille M, Bherer L, Duchesne S, Hudon C 27564992
PERFORM

 

Title:The Montreal Cognitive Assessment After Omission of Hearing-Dependent Subtests: Psychometrics and Clinical Recommendations
Authors:Al-Yawer FPichora-Fuller MKPhillips NA
Link:https://pubmed.ncbi.nlm.nih.gov/31018015/
DOI:10.1111/jgs.15940
Publication:Journal of the American Geriatrics Society
Keywords:
PMID:31018015 Category:J Am Geriatr Soc Date Added:2019-06-03
Dept Affiliation: PSYCHOLOGY
1 Department of Psychology, Concordia University, Montréal, Quebec, Canada.
2 Center for Research in Human Development (CRDH), Concordia University, Montréal, Quebec, Canada.
3 Department of Psychology, University of Toronto, Mississauga, Ontario, Canada.
4 Rotman Research Institute, Toronto, Ontario, Canada.

Description:

Objectives: Hearing loss (HL) is the third most common chronic health condition in older adults, yet it is often undiagnosed and/or untreated. Given the association between HL and cognitive impairment, it is expected that many people undergoing cognitive screening may have HL. The Montreal Cognitive Assessment (MoCA) is a brief screening test that assesses a wide range of cognitive functions sensitive to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Although MoCA items were carefully designed to be sensitive to deficits in MCI, they were not designed to take sensory declines into account. In the current investigation, we examined the MoCA's psychometric properties following omission of subtests primarily dependent on hearing status (memory, digit span, attention to letters, and sentence repetition).

Design: Cross-sectional analytic design (retrospective analysis).

Setting: We used the original MoCA validation study data.4 PARTICIPANTS: Groups consisted of healthy controls (N = 90), subjects with MCI (N = 94), and subjects with mild AD (N = 93).

Measurements: We assessed sensitivity and specificity using absolute and proportional cutoff score adjustments. We developed receiver operating characteristics curves to determine the best cutoff values for both MCI and AD patients using different combinations of auditory subtest omissions.

Results: Compared with the original MoCA (MCI sensitivity = 90%; specificity = 87%), MCI sensitivity was substantially reduced (absolute scoring = 43%; proportional scoring = 56%) when all auditory subtests were omitted, with the biggest contribution to the reduction coming from the delayed recall subtest. Excluding three subtests and maintaining the delayed recall had no effect on MCI sensitivity but reduced specificity (sensitivity = 94%, specificity: 71% using proportional scoring). AD sensitivity, in contrast, was not strongly influenced by our manipulation and remained relatively high through all three subtest omission combinations.

Conclusion: The current study highlights the contribution of hearing-dependent subtests on the sensitivity and specificity of the MoCA. Clinical recommendations related to these findings are discussed. J Am Geriatr Soc 67:1689-1694, 2019.





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