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Revista Uruguaya de Medicina Interna

versión On-line ISSN 2393-6797


SPOSITO, Paola  y  LLORENS, Mario. Usefulness of the MoCA (Montreal Cognitive Assessment) as a screening test for mild cognitive impairment in the hypertensive population. Rev. Urug. Med. Int. [online]. 2022, vol.7, n.3, pp.44-52.  Epub 01-Dic-2022. ISSN 2393-6797.


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.


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).


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.


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.


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.

Palabras clave : screening test; mild cognitive impairment; High blood pressure.

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