Chapter 3 70 The HC were interviewed and assessed by research assistants. The assessment was carried out in a single day and included the MoCA, the GDS15 and GAF. 3.2.3 Diagnostic test All referred participants were assessed with a MoCA as soon as possible, within a maximum of 3 months from referral, by a trained research assistant or psychiatric nurse practitioner. This was independent from the diagnostic procedure. The MoCA was assessed during the feedback appointment of the initial assessment when the treatmentplan was presented. The treatment-plan included referral to our memory clinic for further assessment if there was doubt or suspicion of CI. The MoCA consists of one page, covering the cognitive domains of executive function and visuospatial abilities, naming, sort term memory, attention and working memory, language, concentration, verbal abstraction, and orientation. It can be carried out within 10 minutes, with a maximum score of 30 indicating no errors were made. Scores were corrected for low education according to instructions, by adding one point to the total score of patients with 12 years of education or less. The original suggested cut-off for the diagnosis of CI was a score of (below) 26 (<26) (Nasreddine et al., 2005). 3.2.4 Reference test The reference test was the diagnosis determined at multidisciplinary team meetings, including an old age psychiatrist, neuropsychologist, and geriatrician. The diagnoses of dementia andMCI were supported by aminimumof a neuropsychological assessment and laboratory tests. Thediagnosesweremade inconsensus, and inaccordance with the MCI criteria as proposed by an international consortium (Winblad et al., 2004; Gauthier et al., 2006), or the Dutch guideline on dementia (Nederlandse Vereniging voor Klinische Geriatrie, 2014). This guideline covers the criteria of -DSM IV for dementia, -NIA-AA / NINCDS-ADRDA for Alzheimer’s disease (McKhann et al., 2011), -NINDS-AIREN / AHA-ASA for Vascular dementia (Román et al., 1993; Gorelick et al., 2011), -Frontotemporal dementia (FTD) according The Lund and Manchester Groups (Neary et al., 1994; Gorno-Tempini et al., 2011; Rascovsky et al., 2011), and the Consensus for Dementia with Lewy Body (McKeith et al., 2005). The MCI group included those with MCI due to psychiatric causes, in accordance with the international consensus (Winblad et al., 2004; Gauthier et al., 2006). No further differentiation of MCI was made in this study. The results of the MoCA were not used to diagnose MCI or Dementia.
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