Cognitive Disorders

Cognitive Function

Mean Annualized Change in Cognitive Functioning in Patients With Cognitive Disorders (N = 1186)

2014 – 2017

AD = Alzheimer disease, FTD = frontotemporal dementia, LBD = Lewy body dementia, MCI = mild cognitive impairment

All patients undergo brief cognitive screening using the Montreal Cognitive Assessment (MoCA). Typically, patients are given the MoCA during their initial visit and at various intervals afterward, and changes in MoCA score can be used to track progression of disease. A score of ≥ 26 is considered normal.

Annualized Change in MoCA Scores by Disease Group (N = 1186)

2014 – 2017

MoCA data were available for analysis for 1186 patients who had at least 2 visits between 2014 and 2017 and 1 visit in 2017. MoCA scores changed by an average of -1.61 points. Standardizing this difference to account for varied follow-up times results in a mean annualized change of -0.87 points, with AD showing the largest annual change (-1.29) and LBD showing the smallest annual change (-0.77).

These results are similar to those found in the literature, where a small study with 8 mild AD patients found a mean annualized change of -1.5,¹ and another featuring 53 MCI patients reported a change of -0.52.²

Change in MoCA Scores by Disease Group (N = 1014)

2017

AD = Alzheimer disease, FTD = frontotemporal dementia, LBD = Lewy body dementia, MCI = mild cognitive impairment, MoCA = Montreal Cognitive Assessment

The graph shows the change in MoCA scores for all patients and by disease group for those with a baseline score ≤ 25. Clinically meaningful change was defined as a change of ≥ 3 points.

References
  1. Costa AS, Reich A, Fimm B, Ketteler ST, Schulz JB, Reetz K. Evidence of the sensitivity of the MoCA alternate forms in monitoring cognitive change in early Alzheimer’s disease. Dement Geriatr Cogn Disord. 2014;37(1-2):95-103.
  2. Krishnan K, Rossetti H, Hynan LS, Carter K, Falkowski J, Lacritz L, Cullum CM, Weiner M. Changes in Montreal Cognitive Assessment Scores over time. Assessment. 2017 Sep;24(6):772-777.