Validating the MoCA for triaging 4 93 Positive and negative predictive values (PPV, NPV) were calculated for the ‘optimal’ cutoff scores as calculated by the Youden’s J index. Boxplots were calculated to understand the distribution of the total MoCA scores for the main diagnostic groups and for their underlying DSM IV diagnosis to further explore the origin of the false positive (FP) and false negative (FN) results. 4.3 Results 4.3.1 Study groups Out of 2206 patients referred to the old age psychiatry clinic, 1337 were deemed ineligible for this study as they were not capable of giving informed consent. The exclusion criteria listed above were applied to exclude the extremes of the spectrum (n=174). Of the remaining 695 patients, 292 were suspected of CI and underwent further assessment at our memory clinic. All were included in calculating the diagnostic accuracy of the MoCA in this setting (figure 1). This resulted in 83 MD, 153 MCI and 56 SNoCI patients. The different underlying disorders are shown in the flowchart (figure 1).The average time between the initial assessment and the assessment of the MoCA was 21.5 days and 60.8 days for diagnosing CI at the memory clinic. Table 2. key demographic and clinical characteristics Dementia (a) MCI (b) SNoCI (c) Total Referred (d) Statistic difference p<0.05 Variable / n 83 153 56 292 Age (SD) range 77.3 (7.5) 59-94 73.9 (8.0) 53-93 71.0 (7.2) 58-85 74.3 (8.0) 53-94 a>b>c Education <12 (%) 52 53 44 51 No sig. Sex F (%) 63 57 56 59 No sig. GAF (SD) 52 (10.2) 57 (12.8) 54 (11.4) 55 (12.0) a<b GDS15 (SD) 6.6 (4.9) 7.7 (4.7) 8.9 (4,3) 8.4 (4.5) No sig. MoCA (SD) 16.7 (4.1) 20.9 (3.8) 23.9 (4.3) 20.3 (4.7) a<b<c range 5-26 3-28 12-30 3-30 Education and sex were compared between a,b,c, with a Chi2 test. Groups a,b,c and were compared with ANOVA. MCI: Mild Cognitive Impairment; SNoCI: Suspected but No Cognitive Impairment; GAF: Global Assessment of Functioning; GDS15: Geriatric Depression Scale 15 question version; MoCA: Montreal Cognitive Assessment.
RkJQdWJsaXNoZXIy MTk4NDMw