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P4–238: The cognitive process approach in assessment of visual perceptual functions can differentiate between Alzheimer's dementia and dementia with Lewy bodies
Author(s) -
Kramberger Milica G.,
Smrdu Maja,
Jensterle Joå¾e,
Trost Maja,
Pirtošek Zvezdan
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.05.1630
Subject(s) - dementia with lewy bodies , audiology , dementia , psychology , neuropsychology , cognition , perception , visual perception , medicine , clinical psychology , psychiatry , disease , neuroscience , pathology
Background: The Mini Mental Status Exam (MMSE) and the Mattis DementiaRating Scale (DRS) have beenwidely used for screening in dementia. In contrast, the Montreal Cognitive Assessment (MoCA) was originally designed for testing Mild Cognitive Impairment (MCI). The aim of this study was to evaluate the accuracy of theMoCA relative to the DRS andMMSE in distinguishing normal comparison (NC) subjects from people with mild to moderate Alzheimer’s disease (AD). Methods: Subjects included 85 patients with mild-to-moderate AD and 108 demographically comparable NC subjects who completed the MMSE, DRS, and MoCA as part of participation in a larger study on informed consent in AD. Receiver Operating Characteristic (ROC) curve analysis was performed to examine the sensitivity and specificity of all three measures in detecting "patient" status. Accuracy was evaluated in terms of area under the curve (AUC), with 95% confidence intervals. Results: We found no MoCA cut-score that provided an ideal balance of sensitivity and specificity, but the AUC for the MoCA (0.905, p<.001; 95%Confidence Interval1⁄4 0.864 to 0.945) was comparable to that for the MMSE (0.933, p<.001; 95% Confidence Interval 1⁄4 .899 to .968), and that for the DRS (AUC 0.922, p<.001; 95% Confidence Interval 1⁄4 .884 to .960). Conclusions: The MoCA showed an overall accuracy equivalent to that of the DRS and MMSE. Overall, these findings suggest the MoCA may have useful role in screening for dementia. However, as no ideal cut-off score yielded both high sensitivity and specificity, selection of a cut-score for interpretation of individual results would have to be guided by consideration of whether false-positive or false-negative errors were a greater concern.