Kirsten Turner

Kirsten Turner |Clyto Access

City University of London, UK


Expertise: Nursing


Kirsten's area of expertise is in the Neurosciences with a particular in Parkinson's disease and dementia. She works as a community Parkinson's disease Specialist nurse for North Ease London Foundation Trust and is the Team Leader for Neuroscience Specialist Nurse Service. Kirsten works at City, University of London one day per week which is usually a Wednesday. Leadership and management of teams, non medical prescribing and Neuroscience Nursing are some of the topics Kirsten lectures in at City, University of London.



Title: Audit to evaluate the validity of The Montreal Cognitive Assessment in the detection of dementia in Parkinson’s


According to the national Parkinson’s UK audit report (2012) only 33% of clinics routinely screen for cognitive dysfunction. A standard assessment tools to detect cognitive dysfunction in neurology and movement disorder clinics was not identified in this Audit. It is estimated that more than 50% of patients report difficulty remembering and exhibit cognitive impairment even in the early stages of Parkinson’s. Prevalence of dementia in Parkinson’s disease is as high as 75% of those who survive more than 10 years. In a community based survey revealed that in early Parkinson’s, 36% of patients had evidence of cognitive impairment at diagnosis, and 3.5 years from diagnosis 10% of the patients had developed dementia .Early identification of cognitive deficit can predict future cognitive decline that may lead to dementia in Parkinson’s. The Montreal Cognitive Assessment has been recognised as a more sensitive tool than the Mini -Mental State Examination for the detection of Dementia in Parkinson’s. Detection of early dementia in conditions such as Parkinson’s is important as this may determine health related quality of life. The MoCA has demonstrated a high sensitivity to detecting mild cognitive deficits through test –retest reliability in patients with Parkinson’s The reported specificity of the MoCA has been enhanced considerably when using a lower cut off of 23/30. The MOCA has been used for 5 years as a diagnostic tool in a nurse led clinic for Parkinson’s. We conducted a service evaluation to collect feasibility data to examine the following:-

1. The sensitivity and specificity of the MOCA, in a cohort of people diagnosed with Parkinson’s disease.
2. The predictive validity of the MOCA for subsequent referral and diagnosis and the likely size of any effect.
3. Indications for practice and service development.

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