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Guidelines support routine cognitive screening, but no screening test is validated in this population. We explored the Montreal Cognitive Assessment (MoCA) as a possible screening test in SCD. We administered the MoCA; a literacy test, the Wide Range Achievement Test, fourth edition (WRAT\u20104); and a health literacy test, the Shortened Test of Functional Health Literacy in Adults (S\u2010TOFHLA) to adults with SCD and gathered clinical variables through chart review. Spearman's rho, Mann\u2013Whitney, and Kruskal\u2013Wallis tests and quantile regression models were used. Among our sample of 49 adults with SCD, the median MoCA score was 25.0 [interquartile range (IQR) 22.0\u201328.0]. Higher educational attainment was associated with MoCA scores (<jats:italic>p\u2009=<\/jats:italic>\u00a00.001). In multivariable models, MoCA scores were associated with S\u2010TOFHLA (<jats:italic>p\u2009=<\/jats:italic>\u00a00.001) and WRAT\u20104 Reading (<jats:italic>p\u2009=<\/jats:italic>\u00a00.002) scores, and overt stroke (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) at the median. This pilot study adds to the limited literature of cognitive screening tests in adults with SCD and demonstrates a relationship between MoCA scores and measures of literacy and health literacy. The MoCA is a promising option for briefly screening for cognitive impairment in adults with SCD, though further study is needed to confirm its validity.<\/jats:p>","DOI":"10.1111\/bjh.18188","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T23:44:29Z","timestamp":1649288669000},"page":"382-390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The Montreal cognitive assessment as a cognitive screening tool in sickle cell disease: Associations with clinically significant cognitive domains"],"prefix":"10.1111","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2742-1617","authenticated-orcid":false,"given":"Macy L.","family":"Early","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins School of Medicine  Baltimore Maryland 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-9752","authenticated-orcid":false,"given":"Lydia H.","family":"Pecker","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7332-8777","authenticated-orcid":false,"given":"Eboni I.","family":"Lance","sequence":"additional","affiliation":[{"name":"Neurology and Developmental Medicine Kennedy Krieger Institute  Baltimore Maryland USA"},{"name":"Department of Neurology Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lanzkron","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins School of Medicine  Baltimore Maryland 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