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Cognitive neurology
Research paper
Defining and validating a short form Montreal Cognitive Assessment (s-MoCA) for use in neurodegenerative disease
  1. David R Roalf*1,
  2. Tyler M Moore1,
  3. David A Wolk2,3,
  4. Steven E Arnold2,3,
  5. Dawn Mechanic-Hamilton1,3,
  6. Jacqueline Rick4,
  7. Sushila Kabadi1,
  8. Kosha Ruparel1,
  9. Alice S Chen-Plotkin2,
  10. Lama M Chahine2,
  11. Nabila A Dahodwala2,
  12. John E Duda2,5,
  13. Daniel A Weintraub1,2,4,5,
  14. Paul J Moberg1,2,3
  1. 1Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3Alzheimer's Disease Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  4. 4Udall Center for Parkinson's Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  5. 5Parkinson's Disease Research, Education and Clinical Center (PADRECC) at the Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr David R Roalf, Department of Psychiatry, Neuropsychiatry Section, Brain Behavior Laboratory, Hospital of the University of Pennsylvania, 10th Floor, Gates Building, Philadelphia, PA 19104, USA; roalf{at}upenn.edu

Abstract

Introduction Screening for cognitive deficits is essential in neurodegenerative disease. Screening tests, such as the Montreal Cognitive Assessment (MoCA), are easily administered, correlate with neuropsychological performance and demonstrate diagnostic utility. Yet, administration time is too long for many clinical settings.

Methods Item response theory and computerised adaptive testing simulation were employed to establish an abbreviated MoCA in 1850 well-characterised community-dwelling individuals with and without neurodegenerative disease.

Results 8 MoCA items with high item discrimination and appropriate difficulty were identified for use in a short form (s-MoCA). The s-MoCA was highly correlated with the original MoCA, showed robust diagnostic classification and cross-validation procedures substantiated these items.

Discussion Early detection of cognitive impairment is an important clinical and public health concern, but administration of screening measures is limited by time constraints in demanding clinical settings. Here, we provide as-MoCA that is valid across neurological disorders and can be administered in approximately 5 min.

https://doi.org/10.1136/jnnp-2015-312723

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    Footnotes

    • *equal contribution. DRR and TMM contributed equally to this study.

    • Contributors DRR was involved in drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, acquisition of data, statistical analysis, study supervision. DRR takes the role of principal investigator, has access to all of the data and takes responsibility for the data, accuracy of data analysis and conduct of the research. DRR acknowledges and shares equal contribution as first author with TMM. DRR will serve as the corresponding author. TMM was involved in drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, acquisition of data, statistical analysis. TMM acknowledges and shares equal contribution as first author with DRR. DAW and SEA were involved in study concept or design, accepts responsibility for conduct of research and will give final approval, study supervision, obtaining funding. DM-H, JR and SK were involved in aggregation of data, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval. KR was involved in analysis or interpretation of data, statistical analysis, and accepts responsibility for conduct of research and will give final approval, acquisition of data. ASC-P, LMC, NAD and JED accept responsibility for conduct of research and will give final approval, study supervision, obtaining funding. DAW was involved in study concept or design, accepts responsibility for conduct of research and will give final approval, study supervision, obtaining funding. PJM was involved in drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, study supervision.

    • Funding This work was supported by NIA AG10124, NIMH K01 MH102609 (DRR), the Marian S Ware Alzheimer's Program/National Philanthropic Trust, and the Institute of Aging and Alzheimer's Disease Core Center Pilot Funding Program (DRR). University of Pennsylvania Center of Excellence for Research on Neurodegenerative Diseases (CERND). Penn Udall Center grant: NINDS P50-NS-053488.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Institutional Review Board at the University of Pennsylvania and Philadelphia Veterans Affairs Center.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional data are included in the online supplementary appendix and materials. Data and statistical code for are available on request.