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Abstract
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OBJECTIVE: To pilot the use of Montreal Cognitive Assessment (MOCA) as a quick clinical screen for cognitive assessment in traumatic brain injury (TBI) patients.
DESIGN: The study recruited 61 participants with moderate to severe TBI presenting to a tertiary rehabilitation center under the Brain Injury Program. A MOCA questionnaire and neuropsychological battery (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] and Color Trails Test[CTT]) were administered to participants who had completed inpatient rehabilitation.
RESULTS: Receiver Operating Characteristic (ROC) analysis for the MOCA revealed an optimal balance of sensitivity and specificity at 24/25 to discriminate participants who were classified as less than 5 centile on the Total Scale Index on the RBANS. This achieved a sensitivity, specificity, PPV and NPV of 73.9%, 86.5%, 77.3% and 84.2% respectively. ROC analysis for the trail making subtest of the MOCA achieved a sensitivity, specificity, PPV and NPV of 79.4%, 74.1%, 79.4% and 74.1% in identifying patients classified as less than 5 centile on CTT Part 2.
CONCLUSION: The use of MOCA displayed good validity in identifying patients with clinically significant impairment on a standard neuropsychological assessment battery in the study population. However, it may lack sensitivity for estimating mild levels of impairment.
Language: en |