![]() ![]() Additionally, the original cut score of 26 used to identify impairment was developed without fully accounting for other variables that affect test performance (e.g., age, education, sex, and race) and the score has also been shown to identify a high number of false positives in certain populations. First, some studies have demonstrated that its reliability is notably low in nonclinical populations ( Bernstein et al., 2011), which indicates that it should primarily be used only to detect suspected cognitive impairment in clinical patients. Since its inception as a screening measure for MCI, other studies have found the MoCA to outperform the MMSE in screening for general cognitive impairment in Parkinson disease (PD) ( Hoops et al., 2009 Nazem et al., 2009), vascular dementia after acute stroke ( Dong et al., 2010), and Huntington disease (HD) ( Videnovic et al., 2010) as a measure sensitive to early stages of different types of dementia.Īlthough the MoCA has demonstrated its utility as a cognitive screener, there are a few caveats worth noting. More important, the positive predictive value of the MoCA is 89% for both MCI and AD. The total score ranges from 0 to 30 points, and a cut score of 26 has demonstrated very good specificity (by correctly identifying 87% of healthy participants) and excellent sensitivity when differentiating MCI (90%) and Alzheimer disease (AD) (100%) from healthy comparisons. Including more cognitive domains reduces the likelihood that impairments or disorders will be overlooked (e.g., executive dysfunction, a hallmark symptom of vascular dementia). The MoCA also improved upon the MMSE by probing more cognitive domains, including executive functioning, immediate and delayed memory, visuospatial abilities, attention, working memory, language, and orientation to time and place ( Fig. The MoCA was originally developed as a screening tool to correct the shortcomings of the widely used MMSE, which demonstrated an insensitivity to mild cognitive impairment ( Nasreddine et al., 2005). The operation of restriction and flexibility results in a visual marriage between pattern and intuition.Joseph Jankovic MD, in Bradley and Daroff's Neurology in Clinical Practice, 2022 Montreal Cognitive Assessment Other aspects of the lines (their orientation, how often they intersect each other, etc.) are decided by the draftsman as the drawing progresses. The even distribution is conditioned by the dimensions of the wall, giving each iteration of the drawing a different level of density. ![]() ![]() Lines are applied at the singular discretion of the draftsman, who is instructed only to maintain the length of the lines and appearance of evenness across the surface of the wall. ![]() The number of lines drawn here is derived from a traditional Eastern concept that ten thousand is a unit emblematic of all inconceivably large numbers. Noteworthy in Wall Drawing 86 is the disparity between the simplicity of the instructions and the seeming chaos they produce on the wall. Additionally, LeWitt relaxed the requirement of applying lines in only the four absolute directions, fostering new relationships between his verbal instructions, the performance of those instructions, and the surface on which those instructions are performed. Whereas bands of parallel lines characterized his earlier graphite wall drawings, he later began to isolate the single line as a basic conveyance for his ideas. In 1970, Sol LeWitt further distilled the formal vocabulary he used in his wall drawings. Ten thousand lines about 10 inches (25 cm) long, covering the wall evenly. ![]()
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