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Temporal stability and responsiveness of the Montreal Cognitive Assessment following acquired brain injury
Patricia A Lim1, Alison M McLean2,3, Christiane Kilpatrick3
1a Division of Physical Medicine and Rehabilitation , The University of British Columbia , Vancouver , BC , Canada .
Objectives:
To evaluate the temporal stability and responsiveness of the Montreal Cognitive Assessment (MoCA) in acquired brain injury (ABI).
Research Design And Methods:
English-speaking adults with stroke or moderate-to-severe traumatic brain injury were administered alternate forms of the MoCA (version 1, then 2), 6 weeks apart. Chronic group participants (n = 40) were community-dwelling, at least 1 year post-ABI (mean = 12.1 years, SD = 9.0), and presumed clinically stable. Sub-acute group participants (n = 36) were 30.8 days post-ABI (SD = 12.4) and were undergoing intensive rehabilitation. Individuals with an unstable medical or psychiatric condition or severe receptive aphasia were not eligible.
Results:
The chronic group scored 21.6 (SD = 4.5) initially and 22.7 (SD = 3.8) on the second administration, demonstrating a small but significant practise effect (p = 0.009). The Pearson test-re-test correlation coefficient was 0.83. Using reliable change methodology in the chronic group, the 80% confidence interval (CI) for change across the two administrations was -2 to +4, adjusting for practise. Applied to the sub-acute group, 39% improved and 0% declined.
Conclusions:
The MoCA is a brief standardized tool that appears useful for monitoring cognitive change after ABI. The findings enable clinicians to detect statistically reliable change across serial MoCA administrations in individuals with an ABI.
