Assessing Cognitive Impairment in Patients with Epilepsy Using the Montreal Cognitive Assessment (MoCA)
Ahmed Yassin1, Ethar Hazaimeh2, Abdallah AlHusan3, Zaid Miqdadi3, Duaa Bnayan4, Lama Hatamleh4, Sebawe Syaj3, Yasmeen Alabdallat5, Salma Bashayreh2, Khaled El-Salem2
1Chair of Department of Neurology, 2Department of Neurology, 3Faculty of Medicine, Jordan University of Science and Technology, 4Jordan University of Science and Technology, 5Faculty of medicine, Hashemite University
Objective:
To assess cognitive impairment in epilepsy patients using MoCA test
Background:
Epilepsy is a significant neurological condition associated with cognitive impairment. We aim to assess the Montreal Cognitive Assessment (MoCA) score in patients with epilepsy and compare it with non-epilepsy patients.
Design/Methods:
All patients with epilepsy who visited the neurology clinic in a single tertiary hospital between January and October 2023 were screened using MoCA, and their scores were compared to an exploratory group of non-epilepsy patients.
Results:
A total of 77 patients were included; 44 (59%) were females, the mean age was 32 years, 62 (81%) had epilepsy, and 15 (19%) were non-epilepsy patients. The overall mean MoCA score was 22.2 (SD: 6.0). The Mean MoCA score was significantly lower in patients with epilepsy compared to non-epilepsy patients (20.8 vs. 27.9, p-value < 0.001). Among epilepsy patients, MoCA was significantly higher in those with bachelor’s and diploma degrees compared to others with high school degrees (mean: 24.4 vs. 24.3 vs. 19.2, p-value<0.001). The univariate regression model showed a score decrease of 5.12 with high-school education (multivariable: 2.8 decrease) and a 6.02 decrease in patients with a history of suicidal attempts (multivariable: 5.82 decrease) while non-epilepsy patients had a 7.03 increase in score (multivariable: 3.77 increase). Although insignificant in the univariate model, in the multivariable analysis, normal EEG was associated with a 3.13 increase in score, while abnormal EEG (with slowing and/or epileptiform discharges) was associated with a 5.01 decrease in score.
Conclusions:
Our findings showed that epilepsy was associated with lower MoCA scores, especially in those with lower educational levels, a history of suicidal attempts, or abnormal EEG.