Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired
BackgroundHearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual versio...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
|
| Series: | Frontiers in Aging Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2023.1209385/full |
| _version_ | 1797777340430811136 |
|---|---|
| author | Christiane Völter Hannah Fricke Sarah Faour Gero Lueg Ziad S. Nasreddine Lisa Götze Piers Dawes |
| author_facet | Christiane Völter Hannah Fricke Sarah Faour Gero Lueg Ziad S. Nasreddine Lisa Götze Piers Dawes |
| author_sort | Christiane Völter |
| collection | DOAJ |
| description | BackgroundHearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual version of the Montreal-Cognitive-Assessment was developed and recently validated in English (MoCA-H), with good sensitivity and specificity for identifying cases of dementia. As the MoCA is known to perform differently across languages, revalidation of the German MoCA-H was necessary. The aim of the present study was to assess the diagnostic accuracy of the German MoCA-H among those with normal cognition, mild cognitive impairment (MCI) and dementia and to determine an appropriate performance cut- off.Materials and methodsA total of 346 participants aged 60–97 years (M = 77.18, SD = 9.56) were included; 160 were cognitively healthy, 79 with MCI and 107 were living with dementia based on the GPCOG and a detailed medical questionnaire as well as a comprehensive examination by a neurologist in case of cognitive impairment. Performance cut-offs for normal cognition, MCI and dementia were estimated for the MoCA-H score and z-scores using the English MoCA-H cut-off, the balanced cut-off and the Youden’s Index.ResultsA mean score of 25.49 (SD = 3.01) points in the German MoCA-H was achieved in cognitively healthy participants, 20.08 (SD = 2.29) in the MCI and 15.80 (SD = 3.85) in the dementia group. The optimum cut-off for the detection of dementia was ≤21 points with a sensitivity of 96.3% and a specificity of 90%. In the MCI group, a cut-off range between 22 and 24 points is proposed to increase diagnostic accuracy to a sensitivity and specificity of 97.5 and 90%, respectively.ConclusionThe German MoCA-H seems to be a sensitive screening test for MCI and dementia and should replace commonly used auditory-based cognitive screening tests in older adults. The choice of a cut-off range might help to better reflect the difficulty in clinical reality in detecting MCI. However, screening test batteries cannot replace a comprehensive cognitive evaluation. |
| first_indexed | 2024-03-12T23:02:42Z |
| format | Article |
| id | doaj.art-5479b2743a854bb29f1ab29ea6bbc707 |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-03-12T23:02:42Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-5479b2743a854bb29f1ab29ea6bbc7072023-07-19T08:07:12ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652023-07-011510.3389/fnagi.2023.12093851209385Validation of the German Montreal-Cognitive-Assessment-H for hearing-impairedChristiane Völter0Hannah Fricke1Sarah Faour2Gero Lueg3Ziad S. Nasreddine4Lisa Götze5Piers Dawes6Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, GermanyDepartment of Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, GermanyMoCA Clinic and Institute, Greenfield Park, QC, CanadaDepartment of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, GermanyCentre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, AustraliaBackgroundHearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual version of the Montreal-Cognitive-Assessment was developed and recently validated in English (MoCA-H), with good sensitivity and specificity for identifying cases of dementia. As the MoCA is known to perform differently across languages, revalidation of the German MoCA-H was necessary. The aim of the present study was to assess the diagnostic accuracy of the German MoCA-H among those with normal cognition, mild cognitive impairment (MCI) and dementia and to determine an appropriate performance cut- off.Materials and methodsA total of 346 participants aged 60–97 years (M = 77.18, SD = 9.56) were included; 160 were cognitively healthy, 79 with MCI and 107 were living with dementia based on the GPCOG and a detailed medical questionnaire as well as a comprehensive examination by a neurologist in case of cognitive impairment. Performance cut-offs for normal cognition, MCI and dementia were estimated for the MoCA-H score and z-scores using the English MoCA-H cut-off, the balanced cut-off and the Youden’s Index.ResultsA mean score of 25.49 (SD = 3.01) points in the German MoCA-H was achieved in cognitively healthy participants, 20.08 (SD = 2.29) in the MCI and 15.80 (SD = 3.85) in the dementia group. The optimum cut-off for the detection of dementia was ≤21 points with a sensitivity of 96.3% and a specificity of 90%. In the MCI group, a cut-off range between 22 and 24 points is proposed to increase diagnostic accuracy to a sensitivity and specificity of 97.5 and 90%, respectively.ConclusionThe German MoCA-H seems to be a sensitive screening test for MCI and dementia and should replace commonly used auditory-based cognitive screening tests in older adults. The choice of a cut-off range might help to better reflect the difficulty in clinical reality in detecting MCI. However, screening test batteries cannot replace a comprehensive cognitive evaluation.https://www.frontiersin.org/articles/10.3389/fnagi.2023.1209385/fullMoCA-Hcognitive screeningdementiamild cognitive impairmenthearing loss |
| spellingShingle | Christiane Völter Hannah Fricke Sarah Faour Gero Lueg Ziad S. Nasreddine Lisa Götze Piers Dawes Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired Frontiers in Aging Neuroscience MoCA-H cognitive screening dementia mild cognitive impairment hearing loss |
| title | Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired |
| title_full | Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired |
| title_fullStr | Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired |
| title_full_unstemmed | Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired |
| title_short | Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired |
| title_sort | validation of the german montreal cognitive assessment h for hearing impaired |
| topic | MoCA-H cognitive screening dementia mild cognitive impairment hearing loss |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2023.1209385/full |
| work_keys_str_mv | AT christianevolter validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT hannahfricke validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT sarahfaour validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT gerolueg validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT ziadsnasreddine validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT lisagotze validationofthegermanmontrealcognitiveassessmenthforhearingimpaired AT piersdawes validationofthegermanmontrealcognitiveassessmenthforhearingimpaired |