{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T19:46:12Z","timestamp":1771530372126,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021697","name":"Sykehuset i Vestfold","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021697","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cognitive impairments are common in alcohol use disorder (AUD), but only a few studies have investigated the accuracy of the Montreal Cognitive Assessment (MoCA) in this population. We examined the accuracy and precision of the MoCA in detecting cognitive impairment in a sample of patients with AUD. In addition, we investigated whether the MoCA predicts premature discontinuation from treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A sample of 126 persons with AUD undergoing treatment in specialist health services were administered the MoCA and a battery of 12 neuropsychological tests. Five cognitive domains were derived from the reference tests. A composite total score from these tests was used as a reference criterion for determining correct and incorrect classifications for the MoCA. We analyzed the optimal cut\u2010off score for the MoCA and the accuracy and agreement of classification between the MoCA and the reference tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Receiver operating characteristic (ROC) curve analyzes yielded an area under the curve (AUC) of 0.77 (95% CI [0.67, 0.87]). Applying 25 as the cut\u2010off, MoCA sensitivity was 0.77 and specificity 0.62. The PPV was 0.53. The NPV was 0.84. Using a cut\u2010off score of 24 yielded a lower sensitivity 0.60, but specificity was significantly better i.e., 0.79. PPV was 0.68. The NPV was 0.82. Kappa agreement between MoCA and the reference tests was fair to moderate, 0.38 for the cut\u2010off of 25, and 0.44 for the cut\u2010off of 24. MoCA did not predict discontinuation from treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings indicate limitations in the classification accuracy of the MoCA in predicting cognitive impairment in AUD. Achieving the right balance between accurately identifying impaired cases without including too many false positives can be challenging. Further, MoCA does not predict discontinuation from treatment. Overall, the results do not support MoCA as a time\u2010efficient screening instrument.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15437","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T03:09:38Z","timestamp":1725851378000},"page":"2070-2078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impaired or not impaired: The accuracy of the Montreal Cognitive Assessment in detecting cognitive impairment among patients with alcohol use disorder"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8546-2692","authenticated-orcid":false,"given":"Kristoffer","family":"H\u00f8iland","sequence":"first","affiliation":[{"name":"Vestfold Hospital Trust  T\u00f8nsberg Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Espen Kristian Ajo","family":"Arnevik","sequence":"additional","affiliation":[{"name":"Section for Clinical Addiction Research Oslo University Hospital  Oslo Norway"},{"name":"Department of Psychology University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lien My","family":"Diep","sequence":"additional","affiliation":[{"name":"Oslo Center for Biostatistics and Epidemiology (OCBE) University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tove","family":"Mathisen","sequence":"additional","affiliation":[{"name":"Blue Cross Clinic Skien  Skien Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1086-3067","authenticated-orcid":false,"given":"Katie","family":"Witkiewitz","sequence":"additional","affiliation":[{"name":"Department of Psychology University of New Mexico  Albuquerque New Mexico USA"},{"name":"Center on Alcohol, Substance Use, and Addictions University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Egeland","sequence":"additional","affiliation":[{"name":"Vestfold Hospital Trust  T\u00f8nsberg Norway"},{"name":"Department of Psychology University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2021.100340"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11065\u2010013\u20109228\u20103"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2014.00078"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/23279095.2021.1895791"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/19315864.2018.1469701"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2018.1468923"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2013.07.007"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14659891.2018.1497102"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0017260"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/00952990.2012.670866"},{"key":"e_1_2_8_12_1","volume-title":"D\u2010KEFS examiner's manual","author":"Delis D.C.","year":"2001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.09.030"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1027\/1016\u20109040\/a000102"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13547"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2010.04.008"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2018.11.010"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000528921"},{"key":"e_1_2_8_19_1","unstructured":"H\u00f8iland K. 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