To achieve this, the ability to distinguish between HD patients with and without cognitive impairment, the sensitivity, specificity and predictive values of the MoCA were assessed. Therefore our primary goal was to further evaluate the MoCA as a brief screening tool for cognitive impairment in HD patients in comparison to a comprehensive cognitive testing. Recently, the MoCA was also recommended as a standardized approach to cognitive assessment in patients undergoing HD. Alzheimer's dementia (AD), cerebral small vessel disease, and other medical conditions such as cardiovascular disease, as well as being able to discriminate between mild cognitive impairment and elderly controls. Accordingly, the MoCA has been evaluated and found to be an adequate screening tool in various clinical populations, e.g. It is generally considered superior to the well-established Mini-Mental State Examination (MMSE) screening test, , since the MoCA not only assesses executive functioning, which may be particularly important in the CKD population, , but also presents a higher sensitivity for mild cognitive impairment. The Montreal Cognitive Assessment (MoCA) is a screening test for cognitive impairment that covers major cognitive domains including episodic memory, language, attention, orientation, visuospatial ability and executive functions, while remaining brief and easy to administer. The necessity has, however, been voiced in earlier studies and the use of short and easy-to-apply cognitive screening tools has been suggested. The call for early detection of cognitive impairment in patients with CKD has yet to be translated to every-day clinical practice. Moreover, cognitive impairment is a significant predictor of mortality in HD patients. In addition to being associated with cerebrovascular disease and potentially other types of brain injury, cognitive impairment may jeopardize treatment adherence by affecting the efficiency of every-day tasks, including correct medication and dietary rules. The prevalence of cognitive impairment in chronic hemodialysis (HD) patients has been estimated at 30–80% –. The association of cognitive impairment and a higher incidence of dementia in patients with chronic kidney disease (CKD) has been increasingly acknowledged over the last few years – and represents an important issue in an already vulnerable population. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. Schulz was in part funded by the Helmholtz Alliance ICEMED - Imaging and Curing Environmental Metabolic Diseases, through the Initiative and Network Fund of the Helmholtz Association. Kathrin Reetz was funded by the Excellence Initiative of the German federal and state governments (DFG ZUK32/1). Costa was supported by a PhD fellowship (SFRH/BD/65743/2009) from Fundação para a Ciência e Tecnologia (FCT, Portugal) and financed by the POPH – QREN Program. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: Ana S. Received: FebruAccepted: AugPublished: October 27, 2014Ĭopyright: © 2014 Tiffin-Richards et al. PLoS ONE 9(10):Įditor: Karl Herholz, University of Manchester, United Kingdom (2014) The Montreal Cognitive Assessment (MoCA) - A Sensitive Screening Instrument for Detecting Cognitive Impairment in Chronic Hemodialysis Patients. Citation: Tiffin-Richards FE, Costa AS, Holschbach B, Frank RD, Vassiliadou A, Krüger T, et al.
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