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( MoCA-Ina )

UNTUK SKRINING GANGGUAN FUNGSI KOGNITIF

Nadia Husein*, Silvia Lumempouw**, Yetty Ramli**, Herqutanto***

Husein dkk.
ABSTRACT

Background : MoCA test is very sensitive in MCI screening. This MoCA test
originated from Canada, which is differing in terms of culture and language from
Indonesia. In order to be applicable in Indonesia, MoCA test have to go through validity
and reliability exercises.
Objective : To develop Indonesian MoCA test instrument in Bahasa Indonesia, that
passed the validaty and reliability test. At the end of the exercise we will get Indonesian
MoCA test version that can be used to do cognitive functional assessment for patients in
Indonesia.
Methods : This research uses cross sectional analysis to measure validity and
calculate consensus rate between two physicians on assessment of the same patients in
RSCM. Research is performed after review and approval from Indonesian Medical Ethic
Comitte in October November 2009. Validity test is performed using Transcultural
World Health Organization ( WHO ) method with reliability analisys test-retest using K
(Kappa) statistic.
Results : MoCA test validation went trhough 7 steps using the WHO Concept. Results
from the research shows that total kappa value between 2 phisicians ( inter rater ) is
0.820, with details for each section are the following : Visuospatial / Executive 0,817;
Naming 0,985; and Attention 0,969. Furthermore, for language is 0.990; abstraction
0,957; memory 0,984 and orientation 1,00.
Conclusions : Indonesian version of MoCA Test (MoCA-Ina) is a valid test
instrument based on transcultural and reliable validation principles. MoCA-Ina is
applicable and can be used by Neurologists and General Practicioners to do assessment
on patiens in Indonesia.
Keywords : MCI, MoCA test, validity test , reliability test

Kognitif pada pasien-pasien di Indonesia.

J Am Geriatr Soc. 2005 Apr;53(4):695-9.


The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive
impairment.
Nasreddine ZS et al.
Author information

Abstract
OBJECTIVES:
To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to
assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state
that often progresses to dementia.
DESIGN:
Validation study.

SETTING:
A community clinic and an academic center.
PARTICIPANTS:
Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93
patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score
> or =17), and 90 healthy elderly controls (NC).
MEASUREMENTS:
The MoCA and MMSE were administered to all participants, and sensitivity and specificity
of both measures were assessed for detection of MCI and mild AD.
RESULTS:
Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the
MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of
78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and
MoCA (100% and 87%, respectively).
CONCLUSION:
MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive
screening tool with high sensitivity and specificity for detecting MCI as currently
conceptualized in patients performing in the normal range on the MMSE.

This study compares the usefulness of Montreal Cognitive Assessment (MoCA) to


Standardized Mini-Mental Status Exam
(SMMSE) for diagnosing mild cognitive impairment (MCI) in Type 2 diabetes mellitus (DM)
population. Methods.Thisprospective
pilot study enrolled 30 community dwelling adults with Type 2 DMaged 50 years and above.
Subjects were assessed using both the
SMMSE and MoCA for MCI. In all subjects, depression and dementia were ruled out using
the DSM IV criteria, and a functional
assessment was done. MCI was diagnosed using the standard test, the European consortium
criteria.
Sensitivity and specificity

analysis, positive and negative predictive values, likelihood ratios and Kappa statistic were
calculated.
Results. In comparison to
consortium criteria, the sensitivity and specificity of MoCA were 67% and 93% in identifying
individuals with MCI, and SMMSE
were 13% and 93%, respectively.The positive and negative predictive values for MoCA were
84% and 56%, and for SMMSE were
66% and 51%, respectively. Kappa statistics showed moderate agreement betweenMoCA and
consortiumcriteria (kappa = 0.4) and
a low agreement between SMMSE and consortium criteria (kappa = 0.07). Conclusion. In
this pilot study, MoCA appears to be a
better screening tool than SMMSE for MCI in the diabetic population.