Validity and Applications of the Montreal Cognitive Assessment for the Assessment of Vascular Cognitive Impairment

Cognitive impairment is common among patients with stroke or other cerebrovascular disease and influences longterm outcome, including occupational functioning. Recognition and monitoring of mild cognitive impairment is thus essential to good patient care. The Montreal Cognitive Assessment (MoCA) has been suggested as a brief screening test of vascular cognitive impairment. This paper presents a critical review of the research literature evaluating the validity and utility of this test with the aim of informing future clinical and research practice. A total of 30 papers employing the MoCA in the context of cerebrovascular disease were identified. Reporting of the methods and results of such studies tended to fall short of the established reporting guidelines. Under-specification of the exclusion criteria applied and their impact make it difficult to assess the potential impact of sampling bias and loss to follow-up. Nevertheless, content validity evidence suggests that the MoCA covers most of the domains that represent cognitive impairment in cerebrovascular disease, with mixed evidence for its preferential sensitivity to the type of cognitive impairment encountered in the context of vascular disease. Evidence clearReceived: March 3, 2013 Accepted: May 10, 2013 Published online: July 30, 2013 Lisa Koski, PhD The Allan Memorial Institute, P2.142 1025 Pine Avenue West, Montreal, QC H3A 1A1 (Canada) E-Mail lisa.koski @ mcgill.ca © 2013 S. Karger AG, Basel 1015–9770/13/0361–0006$38.00/0