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The Montreal Cognitive Assessment (MoCA) in geriatric rehabilitation: psychometric properties and association with rehabilitation outcomes

Published online by Cambridge University Press:  01 August 2011

Lisa Sweet ,
Mike Van Adel ,
Valerie Metcalf ,
Lisa Wright ,
Anne Harley ,
René Leiva  and
Vanessa Taler
Lisa Sweet*
Affiliation:
Memory Disorder Clinic, Bruyère Continuing Care, Ottawa, Ontario, Canada
Mike Van Adel
Affiliation:
Elisabeth Bruyère Research Institute, Ottawa and University of Ottawa, Faculty of Social Sciences, Ottawa, Ontario, Canada
Valerie Metcalf
Affiliation:
Geriatric Rehabilitation Service, Bruyère Continuing Care, Ottawa, Ontario, Canada
Lisa Wright
Affiliation:
Geriatric Rehabilitation Service, Bruyère Continuing Care, Ottawa, Ontario, Canada
Anne Harley
Affiliation:
Geriatric Rehabilitation Service, Bruyère Continuing Care, Ottawa, Ontario, Canada
René Leiva
Affiliation:
Geriatric Rehabilitation Service, Bruyère Continuing Care, Ottawa, Ontario, Canada
Vanessa Taler
Affiliation:
Elisabeth Bruyère Research Institute, Ottawa and University of Ottawa, Faculty of Social Sciences, Ottawa, Ontario, Canada
*
Correspondence should be addressed to: Lisa Sweet, Memory Disorder Clinic, Bruyère Continuing Care, 43 Bruyère Street, Ottawa ON K1N 5C8, Canada. Phone: +1 613–562-6262 ext. 1368; Fax: +1 613–562-6013. Email: LSweet@bruyere.org.
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Abstract

Background: Cognitive status has been reported to be an important predictor of rehabilitation outcome. The Montreal Cognitive Assessment (MoCA) was designed to overcome some of the limitations of established cognitive screening tools such as the Mini-Mental State Examination (MMSE). The purpose of this study is to evaluate the psychometric characteristics of the MoCA as a screening tool in a geriatric rehabilitation program and its ability to predict rehabilitation outcome.

Methods: Forty-seven geriatric rehabilitation program patients participated in the study. Assessments of each patient's functional (Functional Independence Measure) and cognitive status (MMSE and MoCA) were performed. Information on discharge destinations were obtained and rehabilitation efficacy and efficiency scores were calculated.

Results: Significant correlations were found between the MoCA and other cognitive status measures. Cognitive status at admission and successful rehabilitation were also associated. Defining rehabilitation success on the basis of relative functional efficacy (an indicator that includes the patient's potential for improvement), the sensitivity and specificity of the MoCA were 80% and 30% respectively. The attention subscale of the MoCA was also uniquely predictive of rehabilitation success. The attention subscale (cutoff 5/6) of the MoCA had a sensitivity of 40% and specificity of 90%, as did the MMSE.

Conclusions: As a cognitive screening tool, the MoCA appears to have acceptable psychometric properties. Results suggest that the MoCA can have a considerable advantage over the MMSE in sensitivity and equivalence in specificity using both total and attention scale scores. The MoCA may be a more useful measure for detecting cognitive impairment and predicting rehabilitation outcome in this population.

Keywords

mental statuscognitive assessmentMontreal Cognitive Assessmentrehabilitation outcomegeriatric rehabilitation
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 10 , December 2011 , pp. 1582 - 1591
Copyright
Copyright © International Psychogeriatric Association 2011

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