The Montreal Cognitive Assessment (MoCA), a brief screening test developed to detect patients with mild cognitive impairment, is used in clinical settings across North America [Nasreddine et al.: J Am Geriatr Soc 2005;53:695-699]. The MoCA has been demonstrated to be sensitive to cognitive deficits in frontotemporal dementias (FTD) and related disorders [Coleman et al.: Alzheimer Dis Assoc Disord 2016;30:258-263]. Given attentional impairments in patients with FTD, whether and to what extent the abbreviated items on the MoCA may predict performance on corresponding assessments is not known. Testing and demographic data were extracted from a clinical database using a sample of 91 patients with FTD and related disorders. The relationship between MoCA items and corresponding neuropsychological tasks was assessed through McNemar tests and Spearman correlations. While some MoCA items such as letter fluency, orientation, and clock drawing were strongly correlated with the corresponding standard cognitive test, the MoCA trails were insensitive to impairment compared to the full Trail Making B Test (p = 0.01). In contrast, MoCA naming and delayed recall sub-items detected cognitive impairment more frequently than available comparison tests. The MoCA is a sensitive screening measure to detect impairment in patients with FTD and related disorders, but cognitive deficits specific to FTD result in differential performance on MoCA items compared to longer standard cognitive tests.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al: The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695-699.
Dalrymple-Alford J, MacAskill M, Nakas C, Livingston L, Graham C, Crucian G, et al: The MoCA well-suited screen for cognitive impairment in Parkinson disease. Neurology 2010;75:1717-1725.
Salvadori E, Pasi M, Poggesi A, Chiti G, Inzitari D, Pantoni L: Predictive value of MoCA in the acute phase of stroke on the diagnosis of mid-term cognitive impairment. J Neurol 2013;260:2220-2227.
Coleman KK, Coleman BL, MacKinley JD, Pasternak SH, Finger EC: Detection and differentiation of frontotemporal dementia and related disorders from Alzheimer disease using the Montreal Cognitive Assessment. Alzheimer Dis Assoc Disord 2016;30:258-263.
Vogel SJ, Banks SJ, Cummings JL, Miller JB: Concordance of the Montreal cognitive assessment with standard neuropsychological measures. Alzheimers Dement Diagnosis (Amst) 2015;1:289-294.
Lam B, Middleton LE, Masellis M, Stuss DT, Harry RD, Kiss A, et al: Criterion and convergent validity of the montreal cognitive assessment with screening and standardized neuropsychological testing. J Am Geriatr Soc 2013;61:2181-2185.
Moafmashhadi P, Koski L: Limitations for interpreting failure on individual subtests of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol 2013;26:19-28.
Rascovsky K, Hodges JR, Kipps CM, Johnson JK, Seeley WW, Mendez MF, et al: Diagnostic criteria for the behavioral variant of frontotemporal dementia (bvFTD): current limitations and future directions. Alzheimer Dis Assoc Disord 2007;21:S14-S18.
Gorno-Tempini M, Hillis A, Weintraub S, Kertesz A, Mendez M, Cappa SE, et al: Classification of primary progressive aphasia and its variants. Neurology 2011;76:1006-1014.
Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, et al: Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996;47:1-9.
Armstrong MJ, Litvan I, Lang AE, Bak TH, Bhatia KP, Borroni B, et al: Criteria for the diagnosis of corticobasal degeneration. Neurology 2013;80:496-503.
Sabe L, Jason L, Juejati M, Leiguarda R, Starkstein SE: Dissociation between declarative and procedural learning in dementia and depression. J Clin Exp Neuropsychol 1995;17:841-848.
Loonstra AS, Tarlow AR, Sellers AH: COWAT metanorms across age, education, and gender. Appl Neuropsychol 2001;8:161-166.
Rouleau I, Salmon DP, Butters N, Kennedy C, McGuire K: Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease. Brain Cogn 1992;18:70-87.
Wilson BA, Cockburn J, Baddeley AD: The Rivermead Behavioral Memory Test-II. Bury St. Edmunds, Thames Valley Test, 2003.
Shewan CM, Kertesz A: Reliability and validity characteristics of the Western Aphasia Battery (WAB). J Speech Hear Disord 1980;45:308-324.
Corp. I. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp., Released 2016.
Nasreddine ZS, Phillips N, Chertkow H, Rossetti H, Lacritz L, Cullum M, et al: Normative data for the Montreal Cognitive Assessment (MoCA) in a population-based sample. Neurology 2012;78:765-766.
Salmon DP, Thal LJ, Butters N, Heindel WC: Longitudinal evaluation of dementia of the Alzheimer type A comparison of 3 standardized mental status examinations. Neurology 1990;40:1225-1230.
Perri R, Fadda L, Caltagirone C, Carlesimo GA: Word list and story recall elicit different patterns of memory deficit in patients with Alzheimer's disease, frontotemporal dementia, subcortical ischemic vascular disease, and Lewy body dementia. J Alzheimer Dis 2013;37:99-107.
Kertesz A, Jesso S, Harciarek M, Blair M, McMonagle P: What is semantic dementia? A cohort study of diagnostic features and clinical boundaries. Arch Neurol 2010;67:483-489.
Knopman DS, Kramer JH, Boeve BF, Caselli RJ, Graff-Radford NR, Mendez MF, et al: Development of methodology for conducting clinical trials in frontotemporal lobar degeneration. Brain 2008;131:2957-2968.
Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-310.
Larner AJ: Correlation or limits of agreement? Applying the Bland-Altman approach to the comparison of cognitive screening instruments. Dement Geriatr Cogn Disord 2016;42:247-254.
Tractenberg RE, Aisen PS: Agreement in cognitive and clinical assessments in Alzheimer's disease. Dement Geriatr Cogn Disord 2009;27:344-352.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.