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P2‐217: A Study of the Hong Kong Version of the Montreal Cognitive Assessment (HK‐MOCA) as a Predictor of Conversion from Mild Cognitive Impairment to Dementia
Author(s) -
Nin Tang Lap,
Lau Mei Ling,
Chan Chun Chung,
Tam Yuen Yee,
Yung Cho Yiu,
Li Hiu Sze,
Yeung Pui Yu
Publication year - 2016
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.2016.06.1385
Subject(s) - montreal cognitive assessment , dementia , medicine , cognitive impairment , logistic regression , cognition , statistical significance , cognitive decline , demographics , mini–mental state examination , gerontology , disease , psychiatry , demography , sociology
Background: The HK-MoCA is a brief and feasible cognitive screening instrument for use in Chinese older adults in Hong Kong clinical setting. It has been validated that it is much sensitive to detect mild cognitive impairment (MCI) compared with the Cantonese version of Mini-Mental State Examination (CMMSE). However, its use in monitoring the disease progression is largely unknown. Methods:A total of 275 subjects aged over 60 were referred to a public hospital based cognitive clinic for suspected cognitive impairment from 12/2011 to 5/2013. Referred cases were assessed using HK-MoCA on first visit, baseline demographic data were collected, and subtypes of MCI were diagnosed by experienced geriatricians according to DSM-IV criteria. All subjects were followed in the clinic for 2 years. Statistical analysis including descriptive, between groups comparison, and logistic regression were performed. Results:A total of 92 subjects were diagnosed having MCI at first visit. Twenty one (22.8%) were lost in follow-up. There was no statistical difference between the defaulted and follow-up groups with regard to HK-MoCA score and demographics. The age and HKMoCA score (mean/standard deviation) of 71 subjects with follow-up data available was 76.24/8.2 years and 16.85/4.8 respectively. One was dead within a year. Of the remaining 70 patients, 30.0% and 44.3% was converted to dementia at first and second year respectively. There was no statistical significance in age, education and gender between the converter and non-converter groups. However, score of HK-MoCA was significantly lower in the converter group (14.94/5.07 vs 18.73/3.91, p1⁄40.001) and the conversion rates were different among MCI subtypes (Table 1). Logistic regression however confirmed the HK-MoCA score was the only variable to predict conversion (Exp(B) 1⁄4 0.809, p1⁄40.001). The conversion rates were higher with the subjects scoring lower than cut-off scores for MCI and dementia at 1 and 2 year follow-up (Figure 1 & 2). However, the difference in conversion rates was statistically significant with dementia cutoff score of 18/19 (Odd ratio1⁄42.88; CI1⁄4 1.05-7.89; p1⁄40.033) but not with MCI score of 21/22 (Odd ratio1⁄41.86; CI1⁄40.51-6.90; p1⁄40.066). Conclusions: HKMoCA is a sensitive to detect MCI. Individuals with MCI with low HK-MoCA score below dementia cut-off are at greater risk of short-term conversion to dementia. Table 1 Association between recent TBI and annual change in Clinicai Dementia Raring Sum of Boxes