Dataset Information

Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS.

ABSTRACT: The patients with obstructive sleep apnea hypopnea syndrome (OSAHS) tend to develop cognitive deficits, which usually go unrecognized, and can affect their daily life. The Beijing version of the Montreal cognitive assessment (MoCA-BJ), a Chinese version of MoCA, has been used for the assessment of cognitive functions of OSAHS patients in clinical practice. So far, its reliability and validity have not been tested. This study examined the reliability and validity of MoCA-BJ in a cohort of adult OSAHS patients.152 OSAHS patients, ranging from mild, moderate to severe, 49 primary snoring subjects and 40 normal controls were evaluated for cognitive functions by employing both MoCA-BJ and the Mini Mental State Examination (MMSE). Forty of them were re-tested by MoCA-BJ 14 days after the first test. Internal consistency, test-retest reliability, discriminate and concurrent validity of MoCA-BJ were analyzed.Internal consistency reliability by Cronbach's alpha was adequate (0.73). Intra-class correlation coefficient (ICC), an measure of test-retest reliability, was 0.87 (P<0.001). The total MoCA-BJ scores were significant higher in normal controls than in OSAHS groups (p<0.05). The performances of visuospatial ability in severe OSAHS group were significantly weaker than in normal controls and primary snoring group. The performances of executive ability in severe OSAHS patients were weaker than in normal controls. An optimal cut-off between normal controls and non-normal subjects was at 26 points (total MoCA score). Moreover, cut-off between non-severe and severe OSAHS was at 2 points on visuospatial subscale. Analysis of the correlation between MoCA total scores and MMSE total scores revealed a statistically significant, though relatively weak, correlation (r=0.41, P<0.05).In conclusion, our study showed that the Beijing version of the MoCA was reliable and stable. The MoCA-BJ was capable of detecting cognitive dysfunction by visuospatial and total MoCA-BJ score.

SUBMITTER: Chen X

PROVIDER: S-EPMC4514887 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS.

Chen Xiong X Zhang Rui R Xiao Ying Y Dong Jiaqi J Niu Xun X Kong Weijia W

PloS one 20150724 7

<h4>Background</h4>The patients with obstructive sleep apnea hypopnea syndrome (OSAHS) tend to develop cognitive deficits, which usually go unrecognized, and can affect their daily life. The Beijing version of the Montreal cognitive assessment (MoCA-BJ), a Chinese version of MoCA, has been used for the assessment of cognitive functions of OSAHS patients in clinical practice. So far, its reliability and validity have not been tested. This study examined the reliability and validity of MoCA-BJ in ...[more]

PMID: 26208289

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Project description:OBJECTIVE:Cognitive impairment is common among hemodialysis patient, but still lack adequate screening in clinical settings. The Montreal Cognitive Assessment (MoCA) is reportedly to be a sensitive screening tool for cognitive impairment, but its clinical value in patients undergoing hemodialysis is not well established. We aimed to validate the utility of the Beijing version of the MoCA (MoCA-BJ) for detecting cognitive impairment in comparison to a detailed neuropsychological battery as the gold standard. METHODS:We assessed 613 patients undergoing hemodialysis using the MoCA-BJ, the Mini-Mental State Examination (MMSE), and a comprehensive neuropsychological battery. Cognitive dysfunction was defined by the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Spearman's correlation and linear regression were used to estimate the performance of the MoCA-BJ and MMSE in predicting cognitive impairment. A receiver operating characteristic (ROC) curve analysis was used to evaluate the utility of various cutoffs of the MoCA-BJ and MMSE for predicting cognitive impairment. RESULTS:Cognitive impairment was diagnosed in 80.91% (496/613), 75.69% (464/613), and 61.34% (376 /613) of the patients using the DSM-V, MoCA-BJ, and MMSE, respectively. Spearman's rank correlation analysis indicated that the MoCA-BJ was significantly correlated with the neuropsychological battery (rs = 0.639, p<0.001), whereas the MMSE had a weaker correlation with the battery. The area under the ROC curve for cognitive impairment diagnosis using the MoCA-BJ was 0.891 (95% confidence interval: 0.859-0.924) while using the MMSE was 0.823 (95% confidence interval: 0.786-0.860). The optimal MoCA-BJ cutoff score in discriminating patients with and without cognitive impairment was 24 points with a sensitivity of 0.877 and specificity of 0.752. CONCLUSION:The MoCA-BJ offers good sensitivity and specificity levels in detecting cognitive impairment in hemodialysis patients. These findings support the utility of the MoCA-BJ as a screening tool for cognitive impairment in Chinese patients undergoing hemodialysis.

Project description:ObjectiveTo adapt the Appropriateness Evaluation Protocol (AEP) to the specific settings of health care in China and to validate the Chinese version AEP (C-AEP).MethodsForward and backward translations were carried out to the original criteria. Twenty experts participated in the consultancy to form a preliminary version of the C-AEP. To ensure applicability, tests of reliability and validity were performed on 350 admissions and 3,226 hospital days of acute myocardial infraction patients and total hip replacement patients in two tertiary hospitals by two C-AEP reviewers and two physician reviewers. Overall agreement, specific agreement, and Cohen's Kappa were calculated to compare the concordance of decisions between pairs of reviewers to test inter-rater reliability and convergent validity. The use of "overrides" and opinions of experts were recorded as measurements of content validity. Face validity was tested through collecting perspectives of nonprofessionals. Sensitivity, specificity, and predictive values were also reported.ResultsThere are 14 admission and 24 days of care criteria in the initial version of C-AEP. Kappa coefficients indicate substantial agreement between reviewers: with regard to inter-rater reliability, Kappa (?) coefficients are 0.746 (95% confidence interval [CI] 0.644-0.834) and 0.743 (95% CI 0.698-0.767) of admission and hospital days, respectively; for convergent validity, the ? statistics are 0.678 (95% CI 0.567-0.778) and 0.691 (95% CI 0.644-0.717), respectively. Overrides account for less than 2% of all judgments. Content validity and face validity were confirmed by experts and nonprofessionals, respectively. According to the C-AEP reviewers, 18.3% of admissions and 28.5% of inpatient days were deemed inappropriate.ConclusionsThe C-AEP is a reliable and valid screening tool in China's tertiary hospitals. The prevalence of inappropriateness is substantial in our research. To reduce inappropriate utilization, further investigation is needed to elucidate the reasons and risk factors for this inappropriateness.

Project description:OBJECTIVES:While various short variants of the Montreal Cognitive Assessment (MoCA) have been developed, they have not been compared among each other to determine the most optimal variant for routine use. This study evaluated the comparative performance of the short variants in identifying mild cognitive impairment or dementia (MCI/dementia). DESIGN:Baseline data of a cohort study. SETTING:Alzheimer's Disease Centers across the United States. PARTICIPANTS:Participants aged ?50 years (n = 4606), with median age 70 (interquartile range 65-76). MEASURES:Participants completed MoCA and were evaluated for MCI/dementia. The various short variants of MoCA were compared in their performance in discriminating MCI/dementia, using areas under the receiver operating characteristic curve (AUCs). RESULTS:All 7 short variants of MoCA had acceptable performance in discriminating MCI/dementia from normal cognition (AUC 87.7%-91.0%). However, only 2 variants by Roalf et al (2016) and Wong et al (2015) demonstrated comparable performance (AUC 88.4-88.9%) to the original MoCA (AUC 89.3%). Among the participants with higher education, only the variant by Roalf et al had similar AUC to the original MoCA. At the optimal cut-off score of <25, the original MoCA demonstrated 84.4% sensitivity and 76.4% specificity. In contrast, the short variant by Roalf et al had 87.2% sensitivity and 72.1% specificity at its optimal cut-off score of <13. CONCLUSIONS/IMPLICATIONS:The various short variants may not share similar diagnostic performance, with many limited by ceiling effects among participants with higher education. Only the short variant by Roalf et al was comparable to the original MoCA in identifying MCI or dementia even across education subgroups. This variant is one-third the length of the original MoCA and can be completed in <5 minutes. It provides a viable alternative when it is not feasible to administer the original MoCA in clinical practice and can be especially useful in nonspecialty clinics with large volumes of patients at high risk of cognitive impairment (such as those in primary care, geriatric, and stroke prevention clinics).

Dataset Information

Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS.

Publications

Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS.

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