THE MONTREAL COGNITIVE ASSESSMENT (MOCA) AS A MEASURE OF SEVERITY OF AMNESIA IN PATIENTS WITH ALCOHOL-RELATED COGNITIVE IMPAIRMENTS AND KORSAKOFF SYNDROME

Objective: The Montreal cognitive assessment (MoCA) provides an indication of overall cognitive functioning and aims to measure several cognitive domains, such as memory, visuospatial abilities, executive function, attention and concentration, language, fluency, and orientation. It has been found sensitive to detect the (mild) cognitive impairment in patients diagnosed with substance dependence but it is unknown whether the MoCA is able to differentiate between mild and more severe forms of memory impairment, such as differentiating Korsakoff patients, who have severe amnesia, orientation difficulties and executive dysfunctions, from chronic alcoholics, who have cognitive deficits, but do not fulfill the criteria for KS. Method: In order to examine discriminatory power of the MoCA and predictive capacities for the severity of amnesia, both the MoCA and the widely-used Rivermead Behavioural Memory Test (RBMT-3) were administered to 20 patients with Korsakoff syndrome, to 26 patients with non-Korsakoff alcohol related cognitive impairment, and to 33 healthy control subjects. Results: Results suggests that the MoCA has discriminatory power in the diagnosis of patients with alcohol-related cognitive impairments and predictive capacities with regard to the severity of memory impairment. For all comparisons, specific cut-off scores were established. Conclusions: While it can be concluded that the MoCA is a useful screening instrument, it should be stressed that it cannot substitute a more extensive neuropsychological assessment which is essential to the detailed analysis of the cognitive profile and, consequently, for adequate treatment selection.