Correlation Between MoCA and MMSE For the Assessment of Cognition in Schizophrenia
Saida Fisekovic, Amra Memic, Alma Pasalic
Acta Inform Med. 2012; 20(3): 186-189
Introduction: Schizophrenia (Sch) is a complex neurodevelopmental disorder associated with impairment of cognitive function as a central feature, which is confirmed by a number of studies performed on patients suffering from Sch, where clinical symptoms and social functioning of patients are consequences of neurocognitive deficits. Goal: The goal of this study was to assess the clinical usability of the Montreal Cognitive Assessment (MoCA) as a screening instrument for cognitive impairment in schizophrenic patients, alone and in correlation with the Mini-Mental State Examination (MMSE). Material and methods: This clinical prospective study included 30 patients diagnosed with schizophrenia. Patients were selected from Psychiatric Clinic, Clinical Center University of Sarajevo (CCUS) during 2010. For assessment of cognitive impairment we used Montreal Cognitive Assessment Scale (MoCA) and Mini-Mental State Examination (MMSE). Results: From the total number of respondents (n=30), 15/30 (50 %) were males and 15/30 (50 %) were females; age of onset were 23.5±6.69; duration of illness before hospitalization (mean±SD) 32.5±12.9. If we make a comparison of MoCA scale and MMSE under the limit values, then we get that there was 10 true positive, 4 true negative, 14 false positive and 2 false negative. This all leads to sensitivity of MoCA scale again in comparison with the MMSE of 41.7%, specificity 66.7%, positive predictive value of 83.3% and negative predictive value of 22.2%. Conclusions: Our findings provide preliminary evidence that MoCA scale performs well in detecting true positive but it is imprecise in the detection of true negative findings.
1. Goldberg TE, Weinberger DR, Berman KF, Pliskin NH, Podd MH. Further evidence for dementia of the prefrontal type in schizophrenia? A controlled study to teaching the Wisconsin Card Sorting Test. Arch Gen Psychiatry. 1987; 44(11): 1008-1014.
2. Shallice T, Burgess PW, Frith CD. Can the neuropsychological case-study approach be applied to schizophrenia? Psychol Med. 1991; 21(3): 661-673.
3. O’ Carroll R. Cognitive impairment in schizophrenia. Advance in Psychiatric Treatment 2000; 6: 161-168.
4. Mc Kanna PJ. Memory, knowledge and delusions. British Journal of Psychiatry. 1991; 159(14): 36-41.
5. Saykin AJ, Shtasel DL, Gur RE. et al. Neuropsychological deficits in neuroleptic naive patients with first-episode schizophrenia. Archives of General Psychiatry. 1994; 51: 124-131.
6. Lencz T, Smith CW, McLaughlin D, Auther A, Nakayama E, Hovey L, Cornblatt BA. Generalized and specific neuroognitive deficits in prodromal schizophrenia. Biol Psychiatry, 2006; 59: 863-871.
7. Goldman RS, Axelrod BN, Taylor SF. Neuropsychological aspects of shizophrenia. In: I Grant & K.M. Adams (Eds.), Neuropsychological assessment of neuropsychiatric disorders 82nd ed.). New York: Oxford University Press, 1996.
8. Kurtz MM, Wexler BE, Fujimoto M, Shagan DS, Seltzer JC. Symptoms versus neurocognition as predictors of change in life skills in schizophrenia after outpatient rehabilitation. Schizophr Res. 2008; 102(1-3): 303-311.
9. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment (MoCA): A Brief Screening Tool For Mild Cognitive Impairment. Journal of the American Geriatrics Society. 2005; 53: 695-699.
10. Smith T. et al. The Montreal Cognitive Assessment: validity and utility in a memory clinic setting. Can J Psychiatry, 2007 May; 52(5): 329-332.
11. Preda A, Adami A, Kemp AS, Nguyen, D. MoCA: A screening instrument for the assessment of cognition in schizophrenia. In Abstracts from the 13th International Congress on Schizophrenia Research, Schizophrenia Bulletin. 2011; 37(S1): 225-226.
12. Knight R A, Silverstein SM. The role of cognitive psychology in guiding research on cognitive deficits in schizophrenia. In M. F. Lenzenweger & R. H. Dworkin (Eds.), Origins and development of schizophrenia: Advances in experimental psychopathology. Washington DC: APA Press., 1998: 247-295.