Key result
Advanced cardiovascular disease stages, such as heart failure and coronary heart disease, were associated with lower MoCA total, verbal fluency, memory, and orientation scores compared to low risk.
Why the study?
Cognitive impairment is linked to poorer outcomes in cardiovascular disease, but little is known about MoCA scores along the cardiovascular disease continuum.
Do Montreal Cognitive Assessment (MoCA) scores differ across the cardiovascular disease continuum in patients >50 years?
Cross-Sectional (n=80)
No
Do Montreal Cognitive Assessment (MoCA) scores differ across the cardiovascular disease continuum in patients >50 years?
The MoCA can detect cognitive changes in later stages of the cardiovascular disease continuum, such as heart failure, but earlier detection may require more in-depth neuropsychological assessments.
MoCA detects cognitive differences in heart failure; supports its role in advanced stages but leaves open sensitivity earlier in the cardiovascular continuum.
Cardiovascular diseases involve a continuum starting with risk factors, which can progress to coronary heart disease and eventually, to heart failure. Cognitive impairment (CI) is observed as early as cardiovascular risk factors, and in up to 50% of patients with heart failure. Because CI in cardiovascular disease is linked to poorer clinical outcomes, early detection is essential. The Montreal Cognitive Assessment (MoCA) is a screening tool widely used in clinical setting. To date, little is known about MoCA scores along the cardiovascular disease continuum. OBJECTIVE: This study compared performances of different cardiovascular disease profiles on the MoCA and its subscores. METHOD: Eighty participants (>50 years) from two studies conducted at the Montreal Heart Institute were separated into four groups: low cardiovascular risk factors (<2), high cardiovascular risk factors (>2), coronary heart disease, and stable heart failure. ANCOVAs were performed on the total score and on subscores, with sex, age, and education as covariates. RESULTS: Group differences were observed on the MoCA total score (heart failure < low cardiovascular risk), verbal fluency (heart failure < low cardiovascular risk), memory (coronary heart disease < low cardiovascular risk), and orientation (coronary heart disease < low and high cardiovascular risk) subscores. CONCLUSION: Results suggest that the MoCA, particularly verbal fluency and memory subscores, can detect cognitive changes in later stages of the cardiovascular disease continuum, such as heart failure. Detecting cognitive changes earlier on the cardiovascular disease continuum may require more in depth neuropsychological assessments.
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Gagnon et al. (2021) conducted a cross-sectional in Cardiovascular disease (n=80). Advanced cardiovascular disease stages (heart failure, coronary heart disease, high risk) vs. Low cardiovascular risk factors (<2) was evaluated on Montreal Cognitive Assessment (MoCA) total score and subscores. Advanced cardiovascular disease stages, such as heart failure and coronary heart disease, were associated with lower MoCA total, verbal fluency, memory, and orientation scores compared to low risk.
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