Objective: To analyze the effectiveness of Montreal Cognitive Assessment (MoCA) to define dementia in low education level patients with PD in the Brazilian Amazon.

Background: The Montreal Cognitive Assessment (MoCA) is a cognitive assessment test most used in patients with Parkinson’s disease (PD). Although, when applied to patients with PD and low education level, there is evidence that the test can lose diagnostic accuracy.

Method: Cross-sectional study involving patients with PD located at an outpatient clinic of Movement Disorders in Belém, Northern Brazil. Demographic and clinical data of patients were registered, and the MoCA total score and its domains were performed.

Results: 79 patients with PD were evaluated (59.4% men), with a mean age of 60.6 years (SD ± 11.1), mean disease duration of 7.6 years (SD ± 5.1), mean years of education of 9.1 years (SD ± 5.2), 79% of patients in early stage of the disease (Hoehn & Yahr 1 to 2), and mean MoCA total score of 20.5 (SD ± 5.1). According to the MoCA total score, 26.5% of the patients were considered normal, 24% of them had mild cognitive impairment, and 49.3% of patients were diagnosed with dementia, although only one patient had the clinical diagnosis of dementia associated with PD. In addition, there was a floor effect in 5 of the 10 MoCA domains – working memory, repetition, verbal fluency, abstraction and short-term memory (Figure 1). Furthermore, 83.5% of patients had an education level equal to or less than 12 years, and 17.7% of them had an education level under 4 years.

Conclusion: Considering the high rate of people falsely diagnosed with dementia exclusively by MoCA total score, and the floor effect present in several domains of our sample, it is suggested that the education level has a negative impact on accuracy of MoCA to define dementia.

This abstract reports data partially presented at XXII Brazilian Congress of Geriatrics and Gerontology, Annual Brazilian Society of Geriatrics and Gerontology Meeting, Brazil, 04th-06nd March 2021.

References: TUMAS, Vitor et al. Some aspects of the validity of the Montreal Cognitive Assessment (MoCA) for evaluating cognitive impairment in Brazilian patients with Parkinson’s disease. Dementia & neuropsychologia, v. 10, n. 4, p. 333-338, 2016.

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