E-ISSN : 2733-4538
The Montreal Cognitive Assessment (MoCA) was originally developed as a brief screening tool for mild cognitive impairment. However, the NINDS-CSN Vascular Cognitive Impairment Harmonization Standardization working group (Hachinski et al., 2006) suggested that the MoCA would also be a useful instrument for vascular cognitive impairment (VCI). This study was conducted to examine the validity of the newly developed Korean version of the Montreal Cognitive Assessment (K-MoCA) as an instrument for screening of VCI. Eighty-two stroke patients (mean age=71.05±9.53 years, mean education=7.53±5.01 years) with confluent white matter lesions were given the K-MoCA and the K-MMSE with a comprehensive neuropsychological test battery. Among the patients, 36 had a CDR score of 0.5 (Vascular Cognitive Impairment No Dementia, VCI-ND), and 44 had a score of 1.0 or more (Vascular Dementia, VD). Eighty-one matched healthy normal controls (mean age=69.33±8.75 years, mean education =8.14±4.60 years) who met Christensen's health criteria (Christensen et al., 1991) were recruited from the community and were given the K-MoCA and K-MMSE. The K-MoCA was re-administered to 29 normal subjects with a 4-week interval for assessing the test-retest reliability. Strong correlations between the K-MoCA and the K-MMSE were found in VD (r=.90, p<.001), VCI-ND (r=.84, p<.001), and normal controls (r=.79, p<.001). Receiver Operating Curve (ROC) analysis showed that the K-MoCA effectively differentiated stroke (VCI) patients from normal controls (AUC=.80, p<.001). Moreover, it was found that the K-MoCA could differentiate the VCI-ND (AUC=.67, p<.01) as well as the VD (AUC=.90, p<.001) from normal controls, suggesting that the K-MoCA was more sensitive for detecting the VCI-ND than the K-MMSE (AUC=.63, p<.05). Both internal consistency and test-retest reliability of the K-MoCA were significantly high (Cronbach's α=.84; ICC=.85, p<.001). These results suggest that the K-MOCA can be used reliably for screening of VCI. The K-MoCA would help identify individuals in the early stage of cognitive impairment due to cerebrovascular problems. Finally, normative data for the elderly were also presented.
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