{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:53:54Z","timestamp":1778180034535,"version":"3.51.4"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Int Neuropsychol Soc"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1355617724000675_as1\"><jats:title>Objective:<\/jats:title><jats:p>This study aimed to investigate the prevalence and nature of cognitive impairment among severely ill COVID-19 patients and the effectiveness of the Montreal Cognitive Assessment (MoCA) in detecting it.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617724000675_as2\"><jats:title>Method:<\/jats:title><jats:p>We evaluated cognition in COVID-19 patients hospitalized during the first wave (March to June 2020) from six Dutch hospitals, nine months post-discharge, using a comprehensive multi-domain neuropsychological test battery. Test performance was corrected for sex, age, and education differences and transformed into <jats:italic>z<\/jats:italic>-scores. Scores within each cognitive domain were averaged and categorized as average and above (<jats:italic>z<\/jats:italic>-score \u2265 \u22120.84), low average (<jats:italic>z<\/jats:italic>-score \u22121.28 to <jats:italic>\u2212<\/jats:italic>0.84), below average (<jats:italic>z<\/jats:italic>-score \u22121.65 to \u22121.28), and exceptionally low (<jats:italic>z<\/jats:italic>-score &lt; \u22121.65). Patients were classified with cognitive impairment if at least one domain\u2019s <jats:italic>z<\/jats:italic>-score fell below \u22121.65. We assessed the MoCA\u2019s accuracy using both the original cutoff (&lt;26) and an \u201coptimal\u201d cutoff determined by Youden\u2019s index.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617724000675_as3\"><jats:title>Results:<\/jats:title><jats:p>Cognitive impairment was found in 12.1% (24\/199) of patients, with verbal memory and mental speed most affected (6.5% and 7% below \u22121.65, respectively). The MoCA had an area under the curve of 0.84. The original cutoff showed sensitivity of 83% and specificity of 66%. Using the identified optimal cutoff of &lt;24, maintained sensitivity while improving specificity to 81%.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617724000675_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Cognitive impairment prevalence in initially hospitalized COVID-19 patients is lower than initially expected. Verbal memory and processing speed are primarily affected. The MoCA is a valuable screening tool for these impairments and lowering the MoCA cutoff to &lt;24 improves specificity.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1355617724000675","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T08:48:04Z","timestamp":1735894084000},"page":"59-66","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic accuracy of the Montreal Cognitive Assessment in screening for cognitive impairment in initially hospitalized COVID-19 patients: Findings from the prospective multicenter NeNeSCo study"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-0323","authenticated-orcid":false,"given":"Simona","family":"Klinkhammer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esm\u00e9e","family":"Verwijk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gert","family":"Geurtsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelien A.","family":"Duits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Matopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna M.A.","family":"Visser-Meily","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janneke","family":"Horn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjen J.C.","family":"Slooter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline M.","family":"van Heugten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"NeNeSCo study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"S1355617724000675_ref29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"S1355617724000675_ref30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047347"},{"key":"S1355617724000675_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05118-z"},{"key":"S1355617724000675_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15812"},{"key":"S1355617724000675_ref44","unstructured":"Verhage, F. 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