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Floor and ceiling effects on the Montreal Cognitive Assessment in patients with Parkinson’s disease in Brazil

Authors :
Brenda Hanae Bentes Koshimoto
Pedro Renato de Paula Brandão
Vanderci Borges
Henrique Ballalai Ferraz
Artur Francisco Schumacher-Schuh
Carlos Roberto de Mello Rieder
Maira Rozenfeld Olchik
Ignacio Fernandez Mata
Vitor Tumas
Bruno Lopes Santos-Lobato
Source :
Dementia & Neuropsychologia, Vol 17 (2023)
Publication Year :
2023
Publisher :
Associação Neurologia Cognitiva e do Comportamento, 2023.

Abstract

ABSTRACT Parkinson’s disease (PD) is a common neurodegenerative disease associated with cognitive impairment. The Montreal Cognitive Assessment (MoCA) has been used as a recommended global cognition scale for patients with PD, but there are some concerns about its application, partially due to the floor and ceiling effects. Objective: To explore the floor and ceiling effects on the MoCA in patients with PD in Brazil. Methods: Cross-sectional study with data from patients with PD from five Brazilian Movement Disorders Clinics, excluding individuals with a possible diagnosis of dementia. We analyzed the total score of the MoCA, as well as its seven cognitive domains. The floor and ceiling effects were evaluated for the total MoCA score and domains. Multivariate analyses were performed to detect factors associated with floor and ceiling effects. Results: We evaluated data from 366 patients with PD and approximately 19% of individuals had less than five years of education. For the total MoCA score, there was no floor or ceiling effect. There was a floor effect in the abstraction and delayed memory recall domains in 20% of our sample. The ceiling effect was demonstrated in all domains (80.8% more common in naming and 89% orientation), except delayed recall. Education was the main factor associated with the floor and ceiling effects, independent of region, sex, age at evaluation, and disease duration. Conclusion: The floor and ceiling effects are present in specific domains of the MoCA in Brazil, with a strong impact on education. Further adaptations of the MoCA structure for underrepresented populations may reduce these negative effects.

Details

Language :
English
ISSN :
19805764
Volume :
17
Database :
Directory of Open Access Journals
Journal :
Dementia & Neuropsychologia
Publication Type :
Academic Journal
Accession number :
edsdoj.1c0c1c7e480f416894fc72685321708e
Document Type :
article
Full Text :
https://doi.org/10.1590/1980-5764-dn-2023-0022