Cognitive impairment in adults with sickle cell disease (SCD) poses a serious morbidity concern. Routine cognitive screening is encouraged by guidelines; however, no screening method has been shown effective in the population.
The Montreal Cognitive Assessment (MoCA) was investigated as a potential screening tool for SCD. Researchers tested people with SCD on the MoCA, the Wide Range Achievement Test, Fourth Edition (WRAT-4), the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA), and acquired clinical data by looking through their medical records. Quantile regression models and the Spearman’s rho, Mann-Whitney, and Kruskal-Wallis tests were employed.
The median MoCA score among the 49 SCD-affected individuals in our sample was 25.0, with an interquartile range (IQR) of 22.0–28.0. MoCA scores were correlated with higher educational attainment (P=0.001). In multivariable models, MoCA scores at the median were correlated with S-TOFHLA and WRAT-4 Reading scores as well as overt stroke (P=0.03). The results of the MoCA and measures of reading and health literacy were correlated in the pilot investigation, which contributed to the scant literature on cognitive screening tests in patients with SCD.
Although further research was required to validate its validity, the MoCA is a potential tool for quickly screening for cognitive impairment in patients with SCD.