montreal cognitive assessment moca assessment

In general, 80–85 percent of patients with mTBI and with normal CT findings at admission show almost complete recovery of cognitive deficits 12. TBI severity can also be defined according to the radiology findings at presentation using criteria such as Marshall classification 9.Įxecutive functions, memory, visuospatial functions 10, concentration disorders, deficits in information processing and speed 11 are the most vulnerable cognitive functions affected by mild TBI. According to consensus definitions, moderate and severe TBI are characterized by loss of consciousness for greater than 30 minutes and/or PTA persisting for at least 24 hours while mild TBI (mTBI) may occur with or without loss of consciousness and PTA. Using these characteristics, TBI can be classiï¬ed: mild, moderate and severe. The Glasgow Coma Scale (GCS) score, duration of post-traumatic amnesia (PTA) and loss of consciousness (LOC) duration are the major factors used to analyze TBI severity. Various patient related variables also play role in cognitive outcome such as patient’s age, pre-injury neuropsychiatric and cognitive status as well as the quality of post discharge environment. The cognitive outcome post TBI is affected by numerous injury related factors like severity of brain injury and its subsequent complications, associated injuries to other body regions, and the time scale of recovery from injury. Various studies evaluating the presence of cognitive deficits at admission using MoCA have found patient`s age, severity of injury and educational status to be important factors affecting the patients score 8.

MoCA is a freely available tool for use by medical professionals, clinics and hospitals involved in the care of such patients. This screening tool uses various tasks to assess higher-level language abilities, memory and visuospatial and executive functions. Montreal Cognitive Assessment (MoCA) score is a brief assessment tool of global cognitive function which was originally designed for early detection of mild cognitive deficits in patients with Alzheimer disease 7 which has been subsequently validated in different cohorts. There is no single standard easily administrable tool to address these issues in TBI patients. The importance of early assessment of cognitive function post TBI lies in establishing a cognitive prognosis for patients and formulating early intervention plan. In a recent study, TBI has been seen to be associated with later development of dementia and Alzheimer disease 6. The level of resultant cognitive impairment post TBI is seen to correlate with the severity of the brain injury 4, with more grievous injuries resulting in severe and persistent cognitive dysfunction 5. With progressive evolution and introduction of modern monitoring systems and management strategies for TBI, patient survival has increased with concomitant increase in the number of TBI survivors battling with its long-term complications including cognitive dysfunction 3.

It affects the physical, psychosocial and cognitive skills in varying degrees thus causing significant deterioration in the quality of life and impairment of social and economic productivity 2. Traumatic Brain injury (TBI) is one of the most important global health issues which constitutes an increasingly common cause of mortality and a leading cause of morbidity in all age group, especially in young adults 1. Applied on TBI population, it reliably detects cognitive impairment in mild TBI, compared to normal controls and also differentiates cognitive disturbances between mild and severe TBI but its ability to differentiate cognitive function between mild and moderate TBI is equivocal. Montreal cognitive assessment Score (MoCA) is a brief screening tool designed to assess various cognitive domains which has been found to be more sensitive than Mini Mental State Examination (MMSE) score both in Alzheimer disease and subsequently in TBI population. Assessment of cognitive function using classically designed scales is time and resource intensive undertaking which also requires expert neuropsychiatrist referral. Keshav Mishra 1, Devendra Purohit 1*, Somnath Sharma 1ġDepartment of Neurosurgery, SMS Medical College, Jaipur, IndiaĬognitive impairment is a major cause of morbidity and impaired quality of life in traumatic brain Injury (TBI) patients. Montreal cognitive Assessment Score: A Screening Tool for Cognitive Function in Traumatic Brain Injury (TBI) Population

Montreal cognitive assessment moca assessment