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To date, there has not been a time-efficient and resource-conscious way to identify cognitive impairment in patients with substance use disorders SUD. The present study assesses the validity, accuracy, and clinical utility of a brief 10 min screening instrument, the Montreal Cognitive Assessment MoCA , in identifying cognitive impairment among SUD patients. The Neuropsychological Assessment Battery-Screening Module NAB-SM , a minute battery with known sensitivity to the mild-to-moderate deficits observed in SUD patients, was used as the reference criterion for determining agreement, rates of correct and incorrect decision classifications, and criterion-related validity for the MoCA.
The MoCA also showed acceptable sensitivity Using a cut-off of 25 on the MoCA, the overall agreement was These findings indicate that the MoCA provides a time-efficient and resource-conscious way to identify SUD patients with neuropsychological impairment, thus addressing a critical need in the addiction treatment research community.
Cognitive impairment in patients with substance use disorders SUDs contributes to poorer treatment outcomes, including decreased treatment retention Aharonovich, et al. For example, it is associated with less treatment adherence Bates, et al. One of the primary challenges in developing treatments and enhancements for cognitively impaired SUD patients is a lack of knowledge about which patients should be targeted for specialized interventions NIDA, Unfortunately, neuropsychological assessment is typically not an aspect of patient evaluation in substance abuse treatment programs because it is prohibitively time and resource consuming.
Further, studies show that cognitively impaired SUD patients cannot be adequately identified by drug counselors via clinical impression Fals-Stewart, or through self-report Horner, et al. If accounting for and addressing the presence of cognitive deficits among substance abusing patients involves, as a first step, identifying those with neuropsychological impairment, treatment providers and researchers alike need a practical neurocognitive assessment approach for patients with SUDs that is both accurate and comparatively less labor intensive.
Though not a clearly-defined syndrome, MCI is regarded as cognitive dysfunction in excess of normal age-related decline that does not interfere notably with activities of daily living and is often undetectable via standard mental status examination.