Application And Revision Of Montreal Cognitive Assessment In Xi’an Military Sanatorium For Retired Cadres With Mild Cognitive Impairment

The incidence of Alzheimer’s disease heightened with an aging population.Early manifestation of Alzheimer’s disease in the elderly is mild cognitiveimpairment. Early screening and intervention on the occurrence of AD hascrucial clinical value. Montreal cognitive assessment has been widely used withits high sensitivity and specificity in MCI. The study showed MOCA test inscreening mild cognitive impairment in patients is superior to MMSE inventory.Therefore, due to different East-West cultural backgrounds and living habits,MOCA need further revision for unfamiliar illustrations, obscure words,inapprehensive problems existed in fellow countrymen to avoid controversy anddifficulty.The study applies MOCA in screening mild cognitive impairment in Xi’an military retired cadres. Meanwhile, epidemiological diagnosis related riskyfactors. In order to avoid the shortage of Montreal cognitive assessment(MOCA)in practice, it was revised and its reliability and validity was evaluated due toChinese cultural background, living habits and experiences.Aims:1. Applies MOCA in screening mild cognitive impairment in Xi’ansanatorium for retired cadres. Meanwhile, epidemiological diagnosis relatedrisky factors.2. In order to avoid the shortage of Montreal cognitive assessment(MOCA)in practice in Chinese elderly patients, it was revised and its reliability andvalidity was evaluated.Methods:Three hundred and four retired cadres in9xi’an military sanatorium forretired cadres were investigated by random cluster sampling which includespersonal information, prevalence, drug use situation, the original MOCA scale,the revised MOCA scale(One hundred and ninety-six retired cadres)and relatedneuropsychiatry scale. Thirty retired cadres were selected randomly and weretested again after one month.Results:1.64.8%incidence of mild cognitive impairment in Xi’an military sanatoriumfor retired cadres.2. The incidence rate of MCI(67.56%) aged over80was higher than that of70(47.62%), that was significantly different(P<0.05); The incidence rate ofMCI(72%) for those education is less than6years was higher than that of7～12years and over12years which has significant difference(P<0.05); The MCI incidence(80.95%) for never taking exercise was higher than that oftaking regular exercise(60.58%), significantly difference(P<0.01); the MCIincidence of stroke patients(73.33%) were higher than patients(57.64%)haveno stroke that show significant differences(P<0.05).3. Scores for MOCA and MMSE showed that results are significantlyrelated(r=0.81). MOCA scale scores were negatively related to Activities ofdaily living scale(ADL) and Center for epidemiological survey，depressionscale(CES-D) scores.4. MOCA recension Cronbach,s alpha was0.862， Two-part reliabilitycoefficient was0.862. Correlation between forms scale scores in thecorrelation coefficient of0.669. Thirty retirements were selected randomlyand were tested again after one month. The test of0.831enjoys betterconsistency reliability and reliability.5. The results show that the revised MOCA and the original test has significantcorrelation of0.501~0.942(P<0.05). The revised MOCA factors and totalscore have significant correlation between0.392and0.832.6. The related coefficient of MOCA and MOCA recension was0.878(P<0.01).7. The revised MOCA scale has good reaction degree: the total score of the testshows visual space, language, delayed memory, attention and abstract indifferent age has statistical significance. The results varied in gender betweenvisuospatial executing skills and delayed memory ability which making sensein statistics(P<0.05).The results varied in executive function of visual space,language, attention, space capacity of orientation and education time withstatistically significance(P<0.05).8. When the Score of cut-of-point of the MOCA recension was28, the area inROC curve analyses was0.859（0.809～0.910）, as well as the largest area． Conclusion:1. Higher incidence of mild cognitive impairment in Xi’an military sanatoriumfor retired cadres.2. There are higher incidence of mild cognitive impairment in advanced age,lower education, without physical exercise and brain strock people.3. According with cultural backgrounds and living habits of Chinese eldlypeople，Montreal cognitive assessment(MOCA) recension of Chinese versioncan be easy to operated and clinically used to evaluate and diagnosis Chineseelderly people with MCI.4. The revised MOCA scale has good reliability, validity and reaction degree.