ABSTRACT
Objective To explore feasibility of the Chinese version of MoCA for the detection of vascular cognitive impairment-no dementia (VaCIND) and control in a cross-sectional study. Methods One hundred and three Chinese Han were assessed by the MoCA and MMSE. 64 met criteria for VaCIND and 39 were considered cognitively normal. Sensitivities and specificities were calculated using the recommended cut-off scores,and ROC curve analyses were performed to determine optimal sensitivity and specificity. Results No differences were found between groups on age,gender,education degrees. According to their MoCA scores,cognitive impairments including memory,visuospatial, executive function, attention, language, and orientation sub-scores in VaCIND ((0.44 ± 0.96), (2.13 ±1.40), (1.90 ±1.02), (4.61 ±1.41), (4.23 ±1.40), (5.38 ±1.15)) significantly decreased compared with that in controls((2.92 ± 1.42) ,(3.16 ± 1.08) ,(3.32 ± 1.07) ,(5. 87 ±0.41) ,(5.34 ±0.75), (5.79 ±0. 70)) (P<0. 05). The MMSE scale was insensitive to cognitive impairment as compared with MoCA scale. Using cut-off score of 24,the MoCA exhibited excellent sensitivity (0.923) and specificity (0.906). Conclusion MoCA is a more sensitive instrument than the MMSE for the detection of VaCIND and warrants further investigation regarding its applicability in large group and varying ethnic groups.
ABSTRACT
Objective To investigate outcome and cognitive changes of amnestic mild cognitive impairment (aMCI) in a follow-up study. Methods A cross-sectional and longitudinal parallel cohort study design was conducted among 109 aMCI patients and 104 matched normal controls. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function. Results The scores of neuropsychologic tests in aMCI patients were significantly lower than those in the normal controls( all P＜0.01 ) ,with the largest impairment on 20minutes delayed recall of the auditory verbal memory test ( AVMT), which reflects episodic memory ( aMCI pa-tients :2.50 ± 1.48, normal controls :7.85 ± 1.59, Z = - 12.697, P ＜ 0.01 ); AD was diagnosed in 15 of the 69aMCI patients with a prevalence rate of 22% ,but none was converted to AD in the normal controls. The cognitivechanges of performance in AVMT, CDT, MMSE of the patients in aMCI group (( 3.77 ± 60.83 )%, (6.89 ±28.24) %, (6.13 ± 16.89) % respectively) were significantly poorer than those of the controls group(( - 10.75 ±27.46) %, ( - 5.23 ± 14.05 ) %, ( - 1.11 ± 8.26 ) % respectively) ( all P ＜ 0.05 ). At baseline, demented aMCIperformed poorer in AVMT, CFT, TMT, SDMT, CDT, MMSE when compared to stable. During the follow-up, demented aMCI groups performed significantly poorer than did stable subjects in AVMT, CFT, DST, VFT, SDMT,MMSE ( all P ＜ 0.05 ). Conclusion aMCI is a prodromal period of AD and characterized by episodic memory impairment. The neuropsychologic test is a predictive factor for aMCI to develop AD.