An Automated Montreal Cognitive Assessment MoCA‐Report for Optimal Clinical Management of Alzheimer’s Disease and Initial Eligibility Assessment for Newly Approved Therapies

Background The Montreal Cognitive Assessment (MoCA) is one of the cognitive screening tools most frequently used in primary care. Early detection of Alzheimer’s disease will allow rapid intervention, including initiation of recently approved disease modifying therapies, which carry potential benefits for patients, e.g., maintained cognition and function, along with improved prognosis. However, patients with cognitive impairment detected in primary care are commonly referred to specialty clinics for further evaluation. This causes large volume of referrals and long waiting‐time to cognitive specialists which delay diagnosis and treatment. Therefore, an automated report of cognitive screening with rapid interpretation of the results may allow primary care clinicians to identify the patients with high probability for Alzheimer’s disease and potential eligibility to approved therapies. Method We completed an extensive literature review and gathered data derived from the MoCA that is relevant for clinical management and suitability for approved disease‐modifying therapies. Following this, we developed an automated report for the digital‐MoCA software that will present pertinent information that is applicable for clinical management, staging, conversion to other useful well‐known scales, and initial assessment of eligibility for approved disease modifying therapies. Result Based on published studies, we developed a detailed MoCA‐Report to be automatically generated upon completion of the digital‐MoCA. The MoCA‐Report presents the patients’ score on each subtest as well as the total score in comparison to normative data, the Memory Index Score (MIS), MoCA score conversion to Clinical Dementia Rating Scale, Mini Mental State Examination, and risk for amyloid pathology. The MoCA‐Report also includes relevant information on staging, risk for driving errors, and possibility of conversion to dementia. It is designed to provide primary care clinicians assistance in clinical management, initial identification of eligibility for disease modifying therapies, and selection of referrals to specialty clinics, thus improving patient care and supporting the healthcare systems. Conclusion The MoCA‐Report integrates information and interpretation of cognitive screening in an automated modality, with minimal use of staff and time. Rapid interpretation of the cognitive screening in primary care may support clinical management in a timely manner and promote early detection and inte