Validation of T-MoCA in the Screening of Mild Cognitive Impairment in Chinese Patients With Atrial Fibrillation

Frontiers in Cardiovascular Medicine

article

Jianzeng Dong¹  Changsheng Ma¹  Yiwei Lai¹  Manlin Zhao¹  Chao Jiang¹  Xin Du¹  Zhiyan Wang¹  Jingrui Zhang¹  Yu Bai³  Baolei Xu⁴  Weiwei Zhang⁴  Ribo Tang¹  Caihua Sang¹  Deyong Long¹ 

[1] Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases;Beijing Advanced Innovation Center for Big Data-Based Precision Medicine for Cardiovascular Diseases;School of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Science;Department of Neurology, Beijing Anzhen Hospital, Capital Medical University

关键词: atrial fibrillation;    mild cognitive impairment;    Telephone interviewed Montreal Cognitive Assessment (T-MoCA);    Mini-Mental Status Evaluation (MMSE);    Clinical Dementia Rating (CDR);   

DOI  :  10.3389/fcvm.2022.896846

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Atrial fibrillation (AF) is associated with a high risk of mild cognitive impairment (MCI) and dementia. However, feasible and simple instruments that facilitate the regular assessment of cognitive status in patients with AF remain underdeveloped. Methods Cognitive function was first evaluated using telephone Montreal cognitive assessment (T-MoCA), and then patients were invited for an in-person interview for cognitive assessment using both Clinical Dementia Rating (CDR) and mini-mental status evaluation (MMSE). Using CDR = 0.5 as a reference standard, the ability of T-MoCA and MMSE to discriminate cognitive dysfunction, stratified by education level, was tested by receiver–operating curve (ROC) analysis. The net reclassification index was calculated for comparison between the performance of T-MoCA and MMSE. Results One hundred and one patients completed both telephone and in-person interview. Thirty-five MCI patients were identified as MCI using the criteria of CDR = 0.5. The areas under the ROC curve of T-MoCA were 0.80 (0.71–0.89), 0.83 (0.71–0.95), and 0.85 (0.64–0.92) for all patients, patients with high educational level, and patients with low education level, respectively. The optimal threshold was achieved at 16/17 with a sensitivity of 85.7% and a specificity of 69.7% in overall patients, 15/16 with a sensitivity of 88.2% and a specificity of 64.5% in the low educational level patients, and 16/17 with a sensitivity of 77.8% and a specificity of 87.9% in the high educational level patients. Compared to the criterion MMSE ≤ 27 and MMSE norms for the elderly Chinese community, the stratified T-MoCA threshold improves correct classification by 23.7% ( p = 0.033) and 30.3% ( p = 0.020), respectively. Conclusion T-MoCA is a feasible and effective instrument for MCI screening in patients with AF.

【 授权许可】

CC BY