Session Information
Date: Saturday, November 16, 2019
Session Title: Section Info: Annual Assembly Posters (Non Presentations)
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 8
Disclosures: Matthew Tay, MRCP: Nothing to disclose
Objective: To pilot the use of MoCA as a quick bedside tool for cognitive assessment in traumatic brain injury (TBI) patients.
Design: This was a cross-sectional observational study on adult patients with moderate to severe TBI.
Setting: The patients were recruited from the Brain Injury Program of a tertiary rehabilitation center in Tan Tock Seng Hospital from March to August 2018.
Participants: A total of 93 patients were screened of which 32 were excluded. The reasons for exclusion were inability to participate in cognitive testing and assessment because of significant motor/cognitive deficits (28, including 8 with disorders of consciousness) and presence of PTA (4). In total, 50 outpatients and 11 inpatients met inclusion criteria.
Interventions: A Montreal Cognitive Assessment (MoCA) questionnaire and neuropsychological battery (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] and Color Trails Test) were administered to subjects. As part of the study protocol, the MoCA was administered first, followed by the CTT, then RBANS. Tests were administered in a quiet clinic room.
Main Outcome Measures: Receiver operating characteristics (ROC) curves were constructed to examine the ability of MoCA to identify patients with at least mild-moderate impairment on CTT and RBANS. Cut-off values were then derived at ROC co-ordinate points where both sensitivity and specificity were optimized.
Results: ROC analysis for the MoCA revealed an optimal balance of sensitivity and specificity at 24/25 to discriminate subjects who were classified as less than 5th 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.
Conclusions: 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.
Level of Evidence: Level II
To cite this abstract in AMA style:
Tay M. The Validity of the Montreal Cognitive Assessment for Moderate to Severe Traumatic Brain Injury Patients: A Pilot Study [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/the-validity-of-the-montreal-cognitive-assessment-for-moderate-to-severe-traumatic-brain-injury-patients-a-pilot-study/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-validity-of-the-montreal-cognitive-assessment-for-moderate-to-severe-traumatic-brain-injury-patients-a-pilot-study/