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).