Utility of the Montreal Cognitive Assessment (MoCA) and its subset in HIV-associated neurocognitive disorder (HAND) screening

J Psychosom Res. 2016 Jan:80:53-7. doi: 10.1016/j.jpsychores.2015.11.006. Epub 2015 Nov 23.

Abstract

Objectives: The Montreal Cognitive Assessment (MoCA) is a useful screening tool for mild cognitive impairment. We aimed to know whether the full MoCA and subsets of the full test are effective for detecting HIV-associated neurocognitive disorder (HAND).

Methods: We examined the socio-demographic, clinical, functional, and neuropsychological levels of 194 HIV-infected patients. We compared total scores and scores from each cognitive domain of MoCA between patients with and without HAND. We also examined the utility of subsets of the full test using a few selective domains. The diagnostic accuracies of MoCA and subset composition were evaluated.

Results: The total scores of MoCA (P<0.001) and scores from Trail Making Test-B (P=0.020), attention domain (P=0.005), and immediate (P=0.003) and delayed recall (P=0.002) differed between patients with and without HAND. A subset composed of Trail Making Test-B, rescored serial subtraction, and immediate/delayed recall showed a 69.2% accuracy.

Conclusions: Our results suggest that the MoCA and its subsets alone are not sufficient in screening for HAND. Further studies will be needed to develop a simpler and easier screening tool for HAND based on this study.

Keywords: HIV-associated neurocognitive disorder; Montreal Cognitive Assessment; Neuropsychological test; Screening method.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Dementia Complex / diagnosis*
  • AIDS Dementia Complex / psychology*
  • Adult
  • Attention
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology*
  • Executive Function
  • Female
  • HIV Infections / psychology
  • Humans
  • Language Tests
  • Male
  • Mass Screening
  • Memory, Short-Term
  • Mental Recall
  • Middle Aged
  • Neuropsychological Tests*
  • Reproducibility of Results
  • Socioeconomic Factors
  • Trail Making Test