Montreal Cognitive Assessment (MoCA) Scores in Medically Compromised Patients: A Scoping Review

Objective: The purpose of this review is to critically examine studies that have examined investigated the Montreal Cognitive Assessment (MoCA) and functional or medical outcomes and other health variables in patients with non-neurologic medical conditions. Method: Databases OVID Medline and Embase were systematically searched through April 2020, yielding 281 articles that were separately screened for inclusion. Study characteristics extracted from retained articles are presented in Table S1 (online supplemental materials). Results: Thirty-six articles were retained. Cognitive impairment as assessed by the MoCA was associated with adverse health variables including increased morbidity/mortality, poorer functional abilities, increased length of hospital stay, and increased hospital readmissions in 34 of 36 articles. Conclusions: Cognitive impairment as detected by the MoCA was shown in 34 of 36 studies to be associated with worse functional or medical status compared to those with better cognitive functioning across a variety of medical populations. Further research is needed to better understand how to best use the MoCA to potentially inform treatment planning in medical populations, including referral for more detailed neuropsychological evaluation.