RESULTS
A total of 206 participants almost equally distributed among the two cities were included in our study. Participants´ age ranged from 60 to 87 years old with a mean of 68,8 (SD 5.65). Less than half of them (46,6 %) attended at least 12 years of formal education. The mean number of prescribed drugs was 2,16 (SD 1,69), ranging from 0 to 8 drugs. Table 1 gives a detailled description of the study population.
More than half of the participants in our study (60,68 %) suffered from arterial hypertension and 14,56 % had a diagnosis of diabetes. None of the patients had an official present diagnosis of dementia.
If we use the standard cutoff points of less than 26 points obtained in the MoCA test for the diagnosis of MCI and less than 17 points obtained for diagnosing dementia, then 93,2 % of the participants in our study would be diagnosed with MCI (192 out of 206 patients) and 19,42 % of them with dementia (40 / 206).
However, we should consider that the original validation of points obtained after applying the MoCA test was performed in a high-level education population. Applying a validated threshold (cut-off points)(12, 13) to adjust for years of education, the prevalence of MCI results 75,73 %, whereas the prevalence of dementia 4,37 %, according to MoCA test.
Based on the results of the MoCa / MoCA B test, patients with MCI compared to those without MCI were more males (57,81 % vs 21,43 %), patients from Shkoder (51,56 % vs 7,12 %) and older [69 (8) vs 65 (4)], (p ≤ 0,01).
Based on the results of the mini-cog test, was also noted that the median age of patients with MCI was higher than those without MCI [73 (8) vs 68 (8), (p ≤ 0,01)].
In Table 3 were included for the bivariate logistic regression only the OR (odds ratios) of the variables which presented a value of p ≤ 0,200 in Table 2. The variables of the multivariate logistic regression model were excluded based on the likelihood ratio test.
Multivariate regression analysis showed that men had an elevated risk for MCI compared to women (OR 5,31; 95% CI 1,40 – 20,15), as well as patients from the city of Shkoder compared to patients from Tirana (OR 14,48; 95% CI 1,11 – 4,53), when MoCA / MoCA B was used to detect MCI.
Only for patients with MCI according to mini-cog, more than 7 years of education acted as a protective factor (OR 0,12; 95% CI, 0,05 – 0,33), whereas having 1 to 6 years of education was a risk factor. For each year increase of age the risk of MCI was 1,16 times higher.
There exists a clear difference in the average points of MoCA and Lawton-Brody IADL tests, when patients are divided in two groups considering results in the mini-cog test (mini-cog 1 or 2 vs.mini-cog 3 to 5). Both for MoCA and Lawton-Brody IADL tests, patients in the group with lower mini-cog (1 or 2) have obtained lower average scores compared to the group of patients with mini-cog 3 to 5 (MoCA: 16,04 ± 3,67 vs. 21,24 ± 2,93, Lawton-Brody IADL: 3 ± 1,70 vs. 5,34 ± 1,75).
We estimated that the degree of agreement between the two criteria is 26,21 %, with Kappa 2.38 (SD 1,87) underlining a poor agreement between them (Table 4).