Parkinsonism & related disorders · 2025
Establishing a MoCA cut-off point for cognitive impairment detection in Mexican people living with Parkinson's disease: A comprehensive assessment (level II) approach.
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Hernández-Medrano Ana Jimena, Cervantes-Arriaga Amin, Correa-Medina Erick I, Sánchez-Dinorín Gerardo, Rodríguez-Violante Mayela, Solís-Vivanco Rodolfo
Аннотация
BACKGROUND: Cognitive impairment (CI) is a prevalent and debilitating non-motor symptom of Parkinson's disease (PD), affecting around 25-30 % of the people living with PD (PwP). The Montreal Cognitive Assessment (MoCA) is a widely used tool for detecting CI. Yet, its optimal cut-off score for PwP, particularly within specific populations such as the Mexican demographic, remains inadequately defined.
OBJECTIVE: This study aimed to identify the optimal MoCA cut-off score for detecting CI in Mexican PwP based on a comprehensive assessment (level II), according to the Movement Disorders Society Task Force recommendations.
METHODS: We conducted a cross-sectional study including PwP of Mexican nationality and proficiency in Spanish. Participants underwent global cognitive evaluation using the Mexican version of the MoCA (version 8.1) and a comprehensive neuropsychological assessment (NPA) with at least 2 tests for each of 5 cognitive domains (attention, executive function, language, memory, and visuospatial abilities). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy through the Receiver Operating Characteristic (ROC) curve and Youden index were calculated.
RESULTS: A total of 91 PwP were included. CI prevalence was 26.4 %. A cut-off of ≤24 points yielded a sensitivity of 41.7 %, specificity of 76.1 %, PPV of 38.5 %, NPV of 78.5 %, and diagnostic accuracy of 67.0 %. The ROC analysis indicated an AUC of 0.59 (p < 0.001), with a Youden index of 0.18.
CONCLUSION: These findings underscore the MoCA's utility in the nuanced detection of CI among Mexican PwP, highlighting the need for tailored NPA strategies in this clinical population.
OBJECTIVE: This study aimed to identify the optimal MoCA cut-off score for detecting CI in Mexican PwP based on a comprehensive assessment (level II), according to the Movement Disorders Society Task Force recommendations.
METHODS: We conducted a cross-sectional study including PwP of Mexican nationality and proficiency in Spanish. Participants underwent global cognitive evaluation using the Mexican version of the MoCA (version 8.1) and a comprehensive neuropsychological assessment (NPA) with at least 2 tests for each of 5 cognitive domains (attention, executive function, language, memory, and visuospatial abilities). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy through the Receiver Operating Characteristic (ROC) curve and Youden index were calculated.
RESULTS: A total of 91 PwP were included. CI prevalence was 26.4 %. A cut-off of ≤24 points yielded a sensitivity of 41.7 %, specificity of 76.1 %, PPV of 38.5 %, NPV of 78.5 %, and diagnostic accuracy of 67.0 %. The ROC analysis indicated an AUC of 0.59 (p < 0.001), with a Youden index of 0.18.
CONCLUSION: These findings underscore the MoCA's utility in the nuanced detection of CI among Mexican PwP, highlighting the need for tailored NPA strategies in this clinical population.