Utility of the Montreal Cognitive Assessment (MoCA) and its subset in HIV-associated neurocognitive disorder (HAND) screening

• We assessed the functional and neuropsychological levels of 194 HIV patients.
• We examined the utility of MoCA and its subsets in HAND screening.
• The full MoCA and one subset performed similarly for the detection of HAND.
• The MoCA and its subsets alone were not sufficient in screening for HAND.

ObjectivesThe Montreal Cognitive Assessment (MoCA) is a useful screening tool for mild cognitive impairment. We aimed to know whether the full MoCA and subsets of the full test are effective for detecting HIV-associated neurocognitive disorder (HAND).MethodsWe examined the socio-demographic, clinical, functional, and neuropsychological levels of 194 HIV-infected patients. We compared total scores and scores from each cognitive domain of MoCA between patients with and without HAND. We also examined the utility of subsets of the full test using a few selective domains. The diagnostic accuracies of MoCA and subset composition were evaluated.ResultsThe total scores of MoCA (P < 0.001) and scores from Trail Making Test-B (P = 0.020), attention domain (P = 0.005), and immediate (P = 0.003) and delayed recall (P = 0.002) differed between patients with and without HAND. A subset composed of Trail Making Test-B, rescored serial subtraction, and immediate/delayed recall showed a 69.2% accuracy.ConclusionsOur results suggest that the MoCA and its subsets alone are not sufficient in screening for HAND. Further studies will be needed to develop a simpler and easier screening tool for HAND based on this study.