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C. ZADIKOFF ET AL.
MoCA 26
MoCA 26
Total
50
0
50
28
10
38
78
10
88
DESIGN/METHODS
Inclusion Criteria
Patients with idiopathic PD of at least 5 years duration
presenting for routine follow-up at the Toronto Western
Hospital Movement Disorders Center were asked to
participate.
Exclusion Criteria
Signs or symptoms atypical for idiopathic PD or signicant depression (score 2 on the UPDRS I (Q1.3)).
Data Collection
All patients were in the ON state at the time of
assessment. Items common to both tests were asked only
once using a combined version of the MMSE and
MoCA, and the sequence of items similar in both tests
was alternated from subject to subject to avoid order
effects when comparing the MMSE to MoCA scores.
The primary outcome measure was the proportion of
patients with a score less than 26 on either test. A score
of less than 26 on the MMSE has been used in other
studies as a cutoff providing evidence for cognitive impairment.11,12 A cutoff of 26 in the MoCA was chosen as
this was found to be the score optimizing sensitivity and
specicity in the original study assessing MCI.12
Sample Size Calculation and Analysis
Assuming a frequency of MCI of 40%, a sample size of
198 subjects would provide 80% power for a two-tailed
P-value at a signicant level of 0.05 to detect a 10%
difference in the proportion of subjects screening positive
between the two tests. Proportions were compared using
chi-square tests. Correlations were tested using Spearman
correlation coefcients due to the ordinal nature of the
UPDRS scores. Continuous data are expressed as means
and standard deviation. One point was added to an individuals score if s/he had twelve years or fewer of formal
education, for a total maximum of 30 points.
RESULTS
The study was terminated early due to resource limitations. Eighty-eight subjects (26 F, 62 M) participated. The
mean age of the sample was 65 (/10) years, mean
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Abstract: Dopa responsive Dystonia (DRD) was rst described in 1971 and typically begins at childhood with gait
dysfunction caused by foot dystonia progressing to affect
*Correspondence to: Andrew Singleton, Laboratory of Neurogenetics, National Institutes on Aging, National Institutes of Health, Bethesda, MD 20892. E-mail: singleta@mail.nih.gov
Received 3 May 2007; revised 17 July 2007; accepted 15 October
2007
Published online 28 November 2007 in Wiley InterScience (www.
interscience.wiley.com). DOI: 10.1002/mds.21842