Establishing a MoCA cut-off point for cognitive impairment detection in Mexican people living with Parkinson's disease: A comprehensive assessment (level II) approach

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders Pub Date : 2025-01-08 DOI:10.1016/j.parkreldis.2025.107265

Ana Jimena Hernández-Medrano , Amin Cervantes-Arriaga , Erick I. Correa-Medina , Gerardo Sánchez-Dinorín , Mayela Rodríguez-Violante , Rodolfo Solís-Vivanco

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引用次数: 0

Abstract

Background

Cognitive impairment (CI) is a prevalent and debilitating non-motor symptom of Parkinson's disease (PD), affecting around 25–30 % of the people living with PD (PwP). The Montreal Cognitive Assessment (MoCA) is a widely used tool for detecting CI. Yet, its optimal cut-off score for PwP, particularly within specific populations such as the Mexican demographic, remains inadequately defined.

Objective

This study aimed to identify the optimal MoCA cut-off score for detecting CI in Mexican PwP based on a comprehensive assessment (level II), according to the Movement Disorders Society Task Force recommendations.

Methods

We conducted a cross-sectional study including PwP of Mexican nationality and proficiency in Spanish. Participants underwent global cognitive evaluation using the Mexican version of the MoCA (version 8.1) and a comprehensive neuropsychological assessment (NPA) with at least 2 tests for each of 5 cognitive domains (attention, executive function, language, memory, and visuospatial abilities). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy through the Receiver Operating Characteristic (ROC) curve and Youden index were calculated.

Results

A total of 91 PwP were included. CI prevalence was 26.4 %. A cut-off of ≤24 points yielded a sensitivity of 41.7 %, specificity of 76.1 %, PPV of 38.5 %, NPV of 78.5 %, and diagnostic accuracy of 67.0 %. The ROC analysis indicated an AUC of 0.59 (p < 0.001), with a Youden index of 0.18.

Conclusion

These findings underscore the MoCA's utility in the nuanced detection of CI among Mexican PwP, highlighting the need for tailored NPA strategies in this clinical population.

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建立墨西哥帕金森病患者认知障碍检测的MoCA分界点：一种综合评估（II级）方法

背景：认知障碍（CI）是帕金森病（PD）的一种普遍且衰弱的非运动症状，影响约25- 30%的PD （PwP）患者。蒙特利尔认知评估（MoCA）是一种广泛使用的检测CI的工具。然而，其PwP的最佳分界点，特别是在墨西哥等特定人群中，仍然没有充分界定。目的：本研究旨在根据运动障碍学会特别工作组的建议，根据综合评估（II级）确定墨西哥PwP患者检测CI的最佳MoCA截止评分。方法：采用横断面研究，包括墨西哥国籍的PwP和西班牙语熟练程度。参与者使用墨西哥版MoCA（8.1版）进行全球认知评估，并进行综合神经心理学评估（NPA），其中5个认知领域（注意力、执行功能、语言、记忆和视觉空间能力）中每个领域至少2个测试。计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）以及通过受试者工作特征（ROC）曲线和约登指数进行诊断的准确率。结果：共纳入91例PwP。CI患病率为26.4%。截断≤24点时，敏感性为41.7%，特异性为76.1%，PPV为38.5%，NPV为78.5%，诊断准确率为67.0%。ROC分析显示AUC为0.59 (p)。结论：这些发现强调了MoCA在墨西哥PwP患者CI细微检测中的效用，强调了在该临床人群中定制NPA策略的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.