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Manifestaciones Clínicas

Youssef A Ismail1, Huda A Auf1, Shahd A Sadik1

  • 1Faculty of Medicine Port Said Univeristy, Egypt, Port Said, Port Said, Egypt.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
PubMed
Resumen

El Montreal Cognitive Assessment (MoCA) detecta eficazmente la demencia, demostrando alta sensibilidad y especificidad. Es particularmente útil para descartar la demencia, con un alto valor predictivo negativo (VPN).

Palabras clave:
Montreal Cognitive Assessmentdemenciadeterioro cognitivo leveevaluación cognitivaneuropsicología

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Área de la Ciencia:

  • Neurociencia
  • Gerontología
  • Psicometría

Sus antecedentes:

  • La demencia, clasificada como trastorno neurocognitivo mayor, implica un deterioro cognitivo significativo que afecta la vida diaria.
  • El trastorno neurocognitivo leve (TNC) se diagnostica cuando el deterioro cognitivo es moderado y aún no afecta gravemente las actividades diarias.
  • Se evalúa el Montreal Cognitive Assessment (MoCA) por su sensibilidad y especificidad como herramienta de cribado para trastornos neurocognitivos.

Objetivo del estudio:

  • Evaluar la precisión diagnóstica del MoCA para identificar demencia y deterioro cognitivo leve (MCI).
  • Determinar la idoneidad del MoCA como herramienta de cribado en programas a gran escala.
  • Establecer los puntos de corte óptimos del MoCA para diferenciar los estados cognitivos.

Principales métodos:

  • Análisis de datos de 16.309 participantes mayores de 55 años reclutados en los Centros de Investigación de la Enfermedad de Alzheimer (ADRC) de EE. UU.
  • Los participantes se clasificaron en tres grupos: sin deterioro cognitivo (NoCI), deterioro cognitivo leve (MCI) y demencia, basándose en los registros de pacientes y las evaluaciones cognitivas realizadas por el personal clínico.
  • Se utilizó el National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS), que incluye información diagnóstica completa y puntuaciones del MoCA.

Principales resultados:

  • El MoCA demostró una alta precisión en la detección de demencia frente a NoCI, con una sensibilidad del 83% y una especificidad del 82% en un punto de corte de 21.
  • Para detectar MCI frente a NoCI, el MoCA mostró una sensibilidad del 77% y una especificidad del 69% en un punto de corte de 24.
  • El MoCA exhibió un alto valor predictivo negativo (VPN) en todas las comparaciones, lo que indica su fortaleza para descartar el deterioro cognitivo, en particular la demencia (VPN del 94%).

Conclusiones:

  • Se confirma el MoCA como una herramienta de cribado eficaz para la demencia, con una sólida sensibilidad y especificidad.
  • El alto VPN del MoCA lo convierte en un instrumento fiable para excluir la demencia en entornos clínicos.
  • El MoCA muestra una capacidad moderada para identificar MCI, lo que sugiere su utilidad para el cribado cognitivo general.