Introduction:

Dementia is a priority disease in the health systems of developing countries. 30% of hypertensive patients without compromise of other organs present encephalic vascular damage and deterioration of cognitive functions. It is therefore important to have an adequate screening test.

Objectives:

To evaluate cognitive status in hypertensive patients systematically using the MoCA test. Evaluate its sensitivity and specificity and determine the optimal cut-off point to detect mild cognitive impairment (MCI).

Methodology:

Cross-sectional observational analytical study. Inclusion criteria. Patients over 18 years of age, attended at the High blood pressure (HBP) polyclinic of Hospital Maciel (2017-2021). Exclusion criteria. Motor and sensory difficulties, severe psychiatric illness, illiteracy.

Results:

137 patients with cognitive evaluation were included. Mean age 60.4 ± 12.5 91 (66.4%) female. 103 (77.4%) HBP grade 3, 19 patients with (MCI) (13.9%) and 1 with dementia (0.7%) were detected. The median MoCA score in the group without MCI was 26 and 21.5 in the group with MCI (p =0.0001). With a cut-off point of 26, the MOCA test was altered in 63 patients (49.5%) with a sensitivity of 100% and a specificity of 58.7%. The positive predictive value (PPV) was 28.6% and the negative predictive value (NPV) was 100%. By lowering the cut-off point to 24, the best balance between sensitivity and specificity was achieved (88.9% and 78.9%), respectively. The PPV of 41.0% and VPN of 97.7%. In all patients, the MCI was of the multidomain type. Significant differences were found in all cognitive domains, especially executive function.

Conclusions:

In our study, the MoCA test is shown to be a very useful instrument to detect MCI.The optimal cut-off point to detect MCI in this hypertensive population is 24.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )