Validity of the Montreal Cognitive Assessment Screener in Adolescents and Young Adults With and Without Congenital Heart Disease

Background Cognitive deficits are common, long-term sequelae in children and adolescents with congenital heart disease (CHD) who have undergone surgical palliation. However, there is a lack of a validated brief cognitive screening tool appropriate for the outpatient setting for adolescents with CHD. One candidate instrument is the Montreal Cognitive Assessment (MoCA) questionnaire. Objective The purpose of the research was to validate scores from the MoCA against the General Memory Index (GMI) of the Wide Range Assessment of Memory and Learning, 2nd Edition (WRAML2), a widely accepted measure of cognition/memory, in adolescents and young adults with CHD. Methods We administered the MoCA and the WRAML2 to 156 adolescents and young adults ages 14–21 (80 youth with CHD and 76 healthy controls who were gender and age matched). Spearman’s rank order correlations were used to assess concurrent validity. To assess construct validity, the Mann–Whitney U test was used to compare differences in scores in youth with CHD and the healthy control group. Receiver operating characteristic curves were created and area under the curve, sensitivity, specificity, positive predictive value, and negative predictive value were also calculated. Results The MoCA median scores in the CHD versus healthy controls were (23, range 15–29 vs. 28, range 22–30; p < .001), respectively. With the screening cutoff scores at