Characteristic aspects of the Montreal Cognitive Assessment-J in the differential diagnosis of cognitive impairments

• Published in: Japanese Journal of Medical Technology Vol. 69; no. 4; pp. 527 - 533
• Main Authors: IMAMURA, Eiji, HIRATA, Akiko, FUKUTA, Masako, NAKAMORI, Masahiro, NISHINO, Masami, WAKABAYASHI, Shinnichi, OGAWA, Kanami
• Format: Journal Article
• Language: Japanese
• Published: Japanese Association of Medical Technologists 25.10.2020; 一般社団法人 日本臨床衛生検査技師会
• Subjects: dementia screening; dementia territory medical technologist certification system; Japanese version of Montoreal Cognitive Assessment; neuropsychological examination; 日本語版Montoreal Cognitive Assessment; 神経心理学的検査; 認定認知症領域検査技師制度; 認知症スクリーニング
• ISSN: 0915-8669; 2188-5346
• DOI: 10.14932/jamt.20-8

Recently, the Japanese version of the Montreal Cognitive Assessment (MoCA-J) has been disseminated as a screening method for patients with mild cognitive impairment (MCI). We investigated the relationship between MoCA-J and MRI findings in cognitively normal patients. In addition, we compared the subscores of MoCA-J among various patients with cognitive impairment. We enrolled 75 patients (age, 74.6 ± 9.1 years; 30 females) who visited the outpatient memory care ward from August 2018 to March 2019. The median MoCA-J score was 21 (minimum 8, maximum 30). Among cognitively normal patients (n = 39), periventricular hyperintensity (cerebral white matter lesions) on MR images was independently associated with the MoCA-J score by multivariate analysis. For subscores of MoCA-J, attention and executive function subscores were markedly lower in vascular dementia patients. However, subscores of memory were lower for all the subjects because the memory task was difficult. The MoCA-J score consisted of orientation, memory, visuospatial function, language, attention, and executive function. The proportions of attention and executive function were large, which can be used for the diagnosis of frontal lobe dysfunction. In addition, the memory task was difficult, which made it easier to detect slight memory loss. Because of these characteristic features, MoCA-J is useful for evaluating various cognitive impairments.