Montreal Cognitive Assessment (MoCA) Performance and Domain-Specific Index Scores in AmnesticVersusAphasic Dementia

Objective: The Montreal Cognitive Assessment (MoCA) is a popular and simple-to-administer screening instrument to detect cognitive impairment. The MoCA generates a total score and six domain-specific index scores: (1) Memory, (2) Executive Functioning, (3) Attention, (4) Language, (5) Visuospatial, and (6) Orientation. It is unclear whether these MoCA scores can differentiate between distinct clinical dementia syndromes. This study compared MoCA Index scores between amnestic dementia of the Alzheimer's type (DAT) and primary progressive aphasia (PPA), a language-based dementia. Method: Baseline MoCA data were analyzed from 33 DAT, 37 PPA, and 83 cognitively normal individuals enrolled in the Clinical Core of the Northwestern Alzheimer's Disease Center. A one-way analysis of covariance adjusted for age was used to compare MoCA scores among groups. A logistic regression model was implemented to observe individual likelihood of group affiliation based on MoCA Index scores. Results: The mean MoCA total score was significantly higher in controls compared to both patient groups (p< .001) but did not differ between DAT and PPA groups. However, in accordance with salient clinical features commonly observed in DATversusPPA, Memory and Orientation Index scores were lowest in the DAT group (p< .001), whereas Language and Attention Index scores were lowest in the PPA group (p< .001). Multivariate logistic regression analysis showed that the individual effects of Memory (p= .001), Language (p= .002), and Orientation (p= .025) Indices were significant. Conclusions: MoCA Index scores can help differentiate among distinct cognitive syndromes, suggesting it may be a useful brief screening tool to detect domain-specific cognitive impairment.