{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:18:02Z","timestamp":1770833882098,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Visual impairment has been strongly associated with the incidence of dementia. Appropriate cognitive screening for the elderly with visual impairment is crucial for early identification of dementia and its management. Due to challenges in processing visually presented stimuli among participants, the cut-off score of the Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI), also known as MoCA-BLIND or MoCA-22, was unknown. Besides, the cognitive status of elderly with visual impairment residing in care homes is rarely investigated. The current study aimed to 1) establish the cut-off score for HKMoCA-VI and 2) examine the general cognitive functioning of elderly with visual impairment living in residential homes in Hong Kong in terms of MoCA-VI percentile scores.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>HKMoCA-VI and the Cantonese version of the Mini-Mental State Examination (CMMSE) were administered to 123 visually impaired elderly residents in care homes in Hong Kong. Percentile scores of HKMoCA-VI by age and education level were determined, and the concurrent validity, sensitivity, and specificity of HKMoCA-VI were assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A cut-off score 12 was suggested for HKMoCA-VI, which yielded a sensitivity and specificity of 89.29% and 83.58%, respectively. Moreover, it strongly correlated with CMMSE, indicating satisfactory concurrent validity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>HKMoCA-VI is suggested to be a viable cognitive screening tool for elderly individuals with visual impairment in residential homes. Further modifications to enhance the sensitivity and specificity of the measure are proposed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305426","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T17:37:28Z","timestamp":1719423448000},"page":"e0305426","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Hong Kong version of Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI): Proposed cut-off and cognitive functioning survey of visually impaired elderly in residential homes"],"prefix":"10.1371","volume":"19","author":[{"given":"Calvin Chi Kong","family":"Yip","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0420-2964","authenticated-orcid":true,"given":"Winsy Wing Sze","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calvin Pak Wing","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armstrong Tat San","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"pone.0305426.ref001","unstructured":"World Health Organization, Alzheimer\u2019s Disease International. Dementia: a public health priority [Brochure]. United Kingdom: World Health Organization; 2012."},{"key":"pone.0305426.ref002","unstructured":"World Health Organization. Dementia [Internet]. [Place unknown]: World Health Organization; 2023 [updated 2023 Mar 15; cited 2023 Dec 6]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dementia"},{"key":"pone.0305426.ref003","unstructured":"Department of Health of Hong Kong. Mental health review report. Hong Kong: Department of Health of Hong Kong; 2017 Apr. 243."},{"key":"pone.0305426.ref004","first-page":"77","volume-title":"Hong Kong Population Projections 2017\u20132066","year":"2017"},{"issue":"10248","key":"pone.0305426.ref005","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet Commission","volume":"396","author":"G Livingston","year":"2020","journal-title":"Lancet"},{"issue":"3","key":"pone.0305426.ref006","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.3233\/JAD-210250","article-title":"Visual impairment, eye diseases, and dementia risk: a systematic review and meta-analysis","volume":"83","author":"E Ku\u017ama","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"pone.0305426.ref007","article-title":"Low vision and the risk of dementia: a nationwide population-based cohort study","volume":"10","author":"JS Paik","year":"2020","journal-title":"Sci Rep"},{"issue":"2","key":"pone.0305426.ref008","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1080\/13607863.2022.2077303","article-title":"The association between vision impairment and cognitive outcomes in older adults: a systematic review and meta-analysis","volume":"27","author":"GY Cao","year":"2023","journal-title":"Aging Ment Health"},{"issue":"6","key":"pone.0305426.ref009","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1001\/jamaophthalmol.2020.0959","article-title":"Association of visual impairment with risk of incident dementia in a women\u2019s health initiative population","volume":"138","author":"EM Tran","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"pone.0305426.ref010","article-title":"Association of visual impairment with cognitive decline among older adults in Taiwan","volume":"11","author":"IM Fang","year":"2021","journal-title":"Sci Rep"},{"issue":"11","key":"pone.0305426.ref011","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1093\/gerona\/glaa036","article-title":"Higher dementia incidence in older adults with poor visual acuity","volume":"75","author":"TC Lee","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"pone.0305426.ref012","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1037\/0882-7974.12.1.12","article-title":"Emergence of a powerful connection between sensory and cognitive functions across the adult life span: a new window to the study of cognitive aging?","volume":"12","author":"PB Baltes","year":"1997","journal-title":"Psychol Aging"},{"key":"pone.0305426.ref013","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-017-18419-2","article-title":"Age-related eye disease and participation in cognitive activities","volume":"7","author":"M Varin","year":"2017","journal-title":"Sci Rep"},{"key":"pone.0305426.ref014","unstructured":"Census and Statistics Department of Hong Kong Special Administrative Region. Social data collected via the general household survey: special topics report\u2014persons with disabilities and chronic diseases. Report no. 63, 2021. [Internet] Hong Kong: Census and Statistics Department of Hong Kong Special Administrative Region; 2021 [updated 2021 Dec 17; cited 2023 Dec 7]. https:\/\/www.censtatd.gov.hk\/en\/EIndexbySubject.html?scode=380&pcode=C0000055"},{"issue":"9","key":"pone.0305426.ref015","first-page":"123","article-title":"Alzheimer\u2019s Disease\u2014Why we need early diagnosis","volume":"24","author":"J Rasmussen","year":"2019","journal-title":"Degener Neurol Neuromuscul Dis"},{"issue":"4","key":"pone.0305426.ref016","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"ZS Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"issue":"4","key":"pone.0305426.ref017","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1161\/STROKEAHA.114.007253","article-title":"Montreal Cognitive Assessment 5-minute protocol is a brief, valid, reliable, and feasible cognitive screen for telephone administration","volume":"46","author":"A Wong","year":"2015","journal-title":"Stroke"},{"issue":"3","key":"pone.0305426.ref018","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1080\/13854046.2023.2261634","article-title":"Reliability and validity of the Montreal Cognitive Assessment\u2019s auditory items (MoCA-22)","volume":"38","author":"AR Lord","year":"2024","journal-title":"Clin Neuropsychol"},{"issue":"6","key":"pone.0305426.ref019","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1177\/0145482X1010400606","article-title":"Sensitivity and specificity for the Montreal Cognitive Assessment modified for individuals who are visually impaired","volume":"104","author":"W Wittich","year":"2010","journal-title":"J Visual Impair Blind"},{"key":"pone.0305426.ref020","volume-title":"undergraduate thesis on the","author":"CM Fung","year":"2016"},{"issue":"1","key":"pone.0305426.ref021","article-title":"Validation and cut-off scores of Montreal Cognitive Assessment for elderly visually impaired","volume":"25","author":"NM Fadzil","year":"2022","journal-title":"J Health Transl Med"},{"issue":"1","key":"pone.0305426.ref022","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-016-0328-9","article-title":"Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study","volume":"16","author":"S Bj\u00f6rk","year":"2016","journal-title":"BMC Geriatr"},{"issue":"1","key":"pone.0305426.ref023","article-title":"Factors influencing the deterioration from cognitive decline of normal aging to dementia among nursing home residents. BMC Geriatr","volume":"20","author":"AA Hayajneh","year":"2020","journal-title":"Internet]"},{"issue":"4","key":"pone.0305426.ref024","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1080\/13607863.2011.630377","article-title":"Under-recognition of dementia in long-term care homes in Hong Kong","volume":"16","author":"ST Cheng","year":"2012","journal-title":"Aging Ment Health"},{"key":"pone.0305426.ref025","first-page":"25","article-title":"Reliability and validity of the Cantonese version of mini-mental state examination\u2014a preliminary study","volume":"4","author":"FK Chiu","year":"1994","journal-title":"Hong Kong J Psychiatry"},{"key":"pone.0305426.ref026","doi-asserted-by":"crossref","unstructured":"Woods B, Rai HK, Elliot E, Aguirre E, Orrell M, Spector A. Can cognitive stimulation benefit people with dementia? Cochrane Database of Systematic Reviews [Internet]. 2023; Issue 3. Art. No.: CD005562. https:\/\/www.cochrane.org\/CD005562\/DEMENTIA_can-cognitive-stimulation-benefit-people-dementia.","DOI":"10.1002\/14651858.CD005562.pub3"},{"key":"pone.0305426.ref027","doi-asserted-by":"crossref","unstructured":"Wong WS, Tsang HT, Luk CL, Chiu TS. Effects of applying virtual reality in cognitive stimulation therapy on cognitive and functional communication of people with concurrent dementia and visual impairment: an initial study. Alzheimer\u2019s Association International Conference; 2023; Amsterdam, Netherlands. https:\/\/alz.confex.com\/alz\/2023\/meetingapp.cgi\/Paper\/70728","DOI":"10.1002\/alz.070728"},{"issue":"3","key":"pone.0305426.ref028","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-0035-1555115","article-title":"The impact of age on cognition","volume":"36","author":"DL Murman","year":"2015","journal-title":"Semin Hear"},{"key":"pone.0305426.ref029","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2021.114044","article-title":"The effects of education on cognition in older age: evidence from genotyped siblings","volume":"280","author":"J Fletcher","year":"2021","journal-title":"Soc Sci Med"},{"issue":"3","key":"pone.0305426.ref030","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1590\/1980-5764-dn-2022-0012","article-title":"Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study","volume":"16","author":"R Setiyani","year":"2022","journal-title":"Dement Neuropsychol"},{"issue":"49","key":"pone.0305426.ref031","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000018248","article-title":"Comparison of prevalence and associated risk factors of cognitive function status among elderly between nursing homes and common communities of China: A STROBE\u2014compliant observational study","volume":"98","author":"L Yang","year":"2019","journal-title":"Medicine (Baltimore)"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305426","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T17:37:59Z","timestamp":1719423479000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305426"}},"subtitle":[],"editor":[{"given":"Ryota","family":"Sakurai","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0305426","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,26]]}}}