Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2018-0085
Trends in Psychiatry and Psychotherapy
Original Article

Sensitivity and specificity of the Brazilian version of the Montreal Cognitive Assessment – Basic (MoCA-B) in chronic kidney disease

Sensibilidade e especificidade da versão brasileira do Montreal Cognitive Assessment – Basic (MoCA-B) na doença renal crônica

Thaís Malucelli Amatneeks; Amer Cavalheiro Hamdan

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Abstract

Abstract Introduction Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. Objective To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment – Basic (MoCA-B) for identification of cognitive impairment in the CKD population. Methods This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. Results The MoCA-B has reliable internal consistency (Cronbach’s alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. Conclusions The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.

Keywords

Mental status and dementia tests, psychometrics, kidney diseases, neuropsychological tests

Resumo

Resumo Introdução O comprometimento cognitivo na doença renal crônica (DRC) é comumente associado a distúrbios neuropsiquiátricos. Sendo uma patologia complexa, a DRC, em qualquer estágio, requer que o paciente tenha uma boa compreensão da necessidade de adesão ao medicamento e à nutrição. A triagem cognitiva é o ponto de partida para a detecção de deficiências cognitivas. Objetivo Determinar a especificidade e a sensibilidade da versão em português do Brasil do Montreal Cognitive Assessment – Basic (MoCA-B) para identificação de comprometimento cognitivo na população com DRC. Métodos Este foi um estudo transversal com 163 pacientes com DRC em tratamento hemodialítico. Foram aplicados o Mini Exame do Estado Mental (MEEM) e o MoCA-B. Resultados O MoCA-B obteve consistência interna confiável (alfa de Cronbach = 0,74). Um ponto de corte de ≤ 21 pontos fornece a melhor sensibilidade e especificidade para a detecção de comprometimento cognitivo. A variável educação teve menos impacto no escore total do MoCA-B do que no escore total do MEEM. Conclusões O MoCA-B é um instrumento de triagem adequado para avaliar a cognição global de pacientes em hemodiálise. Os resultados podem ajudar os profissionais de saúde a realizar avaliações e planejar o manejo clínico.

Palavras-chave

Testes de estado mental e demência, psicometria, doença renal, testes neuropsicológicos

References

Matta SM da, Moreira JM, Kummer AM, Barbosa IG, Teixeira AL, Silva ACS. Cognitive alterations in chronic kidney disease: an update. J Bras Nefrol. 2014;36:241-5.

Martins IP, Maruta C, Morgado J, Loureiro C, Tavares J, Freitas V. Predictors of cognitive stability or decline during aging: A longitudinal study in primary care. Appl Neuropsychol Adult. 2018;0:1-13.

Foster R, Walker S, Brar R, Hiebert B, Komenda P, Rigatto C. Cognitive impairment in advanced chronic kidney disease: the Canadian Frailty Observation and Interventions Trial. Am J Nephrol. 2016:473-80.

Ismail Z, Rajji TK, Shulman KI. Brief cognitive screening instruments: an update. Int J Geriatr Psychiatry. 2010;25:111-20.

Nasreddine Z, Phillips N, Bédirian V, Charbonneau S, Whitehead V, Colllin I. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9.

Sarmento ALR. Apresentação e aplicabilidade da versão brasileira da MoCA (Montreal Cognitive Assessment) para rastreio de comprometimento cognitivo leve. 2009.

Julayanont P, Tangwongchai S, Hemrungrojn S, Tunvirachaisakul C, Phanthumchinda K, Hongsawat J. The Montreal Cognitive Assessment - Basic: a screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. J Am Geriatr Soc. 2015;63:2550-4.

Chen K-L, Xu Y, Chu A-Q, Ding D, Liang X-N, Nasreddine ZS. Validation of the Chinese version of Montreal Cognitive Assessment Basic for screening mild cognitive impairment. J Am Geriatr Soc. 2016;64:e285-90.

Saleh AA, Alkholy RSAEHA, Khalaf OO, Sabry NA, Amer H, El-Jaafary S. Validation of Montreal Cognitive Assessment-Basic in a sample of elderly Egyptians with neurocognitive disorders. Aging Ment Heal. 2019;23:551-7.

Duncan BB, Schmidt MI, Giugliani ERJ, Duncan MS, Giugliani C. Medicina ambulatorial: condutas de atenção primária baseadas em evidências. 2013.

Sawilowsky SS. New effect size rules of thumb. J Mod Appl Stat Methods. 2009;8:597-9.

Rambe AS, Fitri FI, Utara US. Correlation between the Montreal Cognitive Assessment- Indonesian version (Moca-INA) and the Mini-Mental State Examination (MMSE) in elderly. J Med Sci. 2017;5:915-9.

Carson N, Leach L, Murphy KJ. A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores. Int J Geriatr Psychiatry. 2017;33:379-88.

Apolinario D, Pegoraro F, Funchal M, Sassaki E, Vitoria A, Pedrini A. Normative data for the Montreal Cognitive Assessment (MoCA) and the Memory Index Score (MoCA‐MIS) in Brazil: adjusting the nonlinear effects of education with fractional polynomials. Int J Geriatr Psychiatry. 2018;33:893-9.

Cherchiglia ML, Machado EL, Szuster DAC, Andrade EIG, Acúrcio FA, Caiaffa WT. Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004. Rev Saude Publica. 2010;44:639-49.

Oliveira APB, Schmidt DB, Amatneeks TM, Santos JC dos, Cavallet LHR, Michel RB. Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence. J Bras Nefrol. 2016;38:411-20.

Ardila A. A Note of caution: normative neuropsychological test performance: effects of age, education, gender and ethnicity: a comment on Saykin et al. (1995). Appl Neuropsychol. 1998;5:51-3.

Morillo LS, Brucki SMD, Nitrini R. Modificações neurobiológicas e cognição no envelhecimento. Neuropsicologia Clínica. 2015:227-41.

Sesso RC, Lopes AA, Thomé FS, Lugon JR, Martins CT. Brazilian chronic dialysis survey 2016. J Bras Nefrol. 2017;39:261-6.

Drew DA, Weiner DE. Cognitive impairment in chronic kidney disease: keep vascular disease in mind. Kidney Int. 2014;85:505-7.

Schneider SM, Malecki AK, Müller K, Schönfeld R, Girndt M, Mohr P. Effect of a single dialysis session on cognitive function in CKD5D patients: a prospective clinical study. Nephrol Dial Transplant. 2015;30:1551-9.

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