Considering Different Montreal Cognitive Assessment Cutoff Scores for Older Adults with Asthma

Overview

Journal Allergy Asthma Proc

Specialties Allergy & Immunology
Pulmonary Medicine

Date 2024 Nov 9

PMID 39517079

Authors

Gali Moritz

Jacqueline H Becker

Jyoti V Ankam

Kimberly Arcoleo

Matthew Wysocki

Roee Holtzer

Juan Wisnivesky

Paula J Busse

Alex D Federman

Sunit P Jariwala

Jonathan M Feldman

Affiliations

Soon will be listed here.

Abstract

There is a greater prevalence of cognitive impairment among ethnic and/or racial minorities, and cognitive impairment is a barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationship between cognitive impairment, assessed by using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Latino participants. In addition, we evaluated whether using two different MoCA cutoff scores influenced the association between cognitive impairment and asthma outcomes. Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N = 165) ages ≥60 years. Cognition was assessed by using the MoCA. Asthma Control Questionnaire, asthma-related quality of life (AQOL), and inhaled corticosteroid (ICS) adherence were assessed by using self-report. ICS dosing was collected through chart review and inhaler technique was observed and rated. Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% cognitive impairment rates, respectively. Cognitive impairment, defined by using the cutoff score of 23, was significantly associated with worse asthma control (p = 0.04) and worse ICS adherence (p = 0.01). With a cutoff score of 26, only AQOL was significantly associated with cognitive impairment (p = 0.03). Race and/or ethnicity moderated the relationship between cognitive impairment and asthma control with a MoCA cutoff score of 23, and between cognitive impairment and AQOL with a MoCA cutoff score of 26. Cognitive impairment in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define cognitive impairment.

Citing Articles

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PMID: 39517073 PMC: 11572940. DOI: 10.2500/aap.2024.45.240089.

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