Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging

Abstract

Objective To compare the utility and diagnostic accuracy of the MoCA and MMSE in the diagnosis of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) in a clinical cohort. Method 321 AD, 126 MCI and 140 older adults with healthy cognition (HC) were evaluated using the the MMSE, MoCA, a standardized neuropsychological battery according to the Consortium to Establish a Registry of Alzheimer’s Disease (CERAD-NB) and an informant based measure of functional impairment, the Dementia Severity Rating Scale (DSRS). Diagnostic accuracy and optimal cut-off scores were calculated for each measure, and a method for converting MoCA to MMSE scores is presented also. Results The MMSE and MoCA offer reasonably good diagnostic and classification accuracy as compared to the more detailed CERAD-NB; however, as a brief cognitive screening measure the MoCA was more sensitive and had higher classification accuracy for differentiating MCI from HC. Complementing the MMSE or the MoCA with the DSRS significantly improved diagnostic accuracy. Conclusion The current results support recent data indicating that the MoCA is superior to the MMSE as a global assessment tool, particularly in discerning earlier stages of cognitive decline. In addition, we found that overall diagnostic accuracy improves when the MMSE or MoCA is combined with an informant-based functional measure. Finally, we provide a reliable and easy conversion of MoCA to MMSE scores. However, the need for MCI-specific measures is still needed to increase the diagnostic specificity between AD and MCI.

Analysis of psychometric features of the Mini-Mental State Examination and the Montreal Cognitive Assessment methods

“…Based on our findings, we may state that the MMSE as well as the MoCA are adequately reliable screening tests. The alpha value found by us (the MMSE α = 0.78 / the MoCA α = 0.81) is lower than the value specified by the MoCA method author (α = 0.83) (Nasreddine et al., 2005); but despite that, these reliability values are sufficient and they are also in accordance with the research findings of the performed psychometric studies (Roalf et al, 2013;Saczynski et al, 2015). Sensitivity and specificity of the MMSE are different in various stages depending on the cut off used.…”

The Montreal Cognitive Assessment (MoCA) in Multiple Sclerosis: Relation to Clinical Features

“…The mean MoCA of 25.86 ± 2.92 in our sample was similar to a smaller sample of individuals with MS [27], 26.02± 2.30 and is in the same range as other neurologic disorders associated with mild cognitive impairment including REM Sleep Behavior Disorder [34] (n=38, 24.34 ± 3.50), or early Parkinson's disease [7] (n=100, 24.9 ±3.1), but is considerably higher than individuals with brain metastasis [36](n=40, 20.53 ± -5.15), cerebral small vessel disease [37] (n=40, 19.2 ± 4.2), Huntington's disease [9](n=53, 21 ±4.4) or Alzheimer's disease [3](n=321,13.0 4 ±6.05) [4,[7][8][9]27,[36][37][38][39].…”

“…Similar to the MMSE, the MoCA is a one-page test, which can be administered in five to ten minutes or less. It assesses more cognitive domains than the MMSE, including short-term memory, visuospatial abilities, executive functions, attention, concentration, working memory, language and orientation [3]. Its sensitivity in detecting MCI is 90%, while that of the MMSE is only 18% [4,2].…”

“…These patients usually score normally on the MMSE but fall below normal range on the MoCA [3,[6][7][8][9].An extensive list of diseases for which the MoCA has been used as an assessment tool can be found on the MoCA website, www.mocatest.org [1].…”

Analysis of entropies based on empirical mode decomposition in amnesic mild cognitive impairment of diabetes mellitus

“…Results showed that the MoCA score is more sensitive to detect the MCI and AD in comparison with MMSE. [59][60][61] In addition, the MoCA has comprehensive coverage of cognitive function, such as executive function attention, attention and delayed recall, while the MMSE lacks these abilities. 62 Recently, Alagiakrishnan et al have compared the usefulness of MoCA with the Standardized MMSE in detecting MCI with T2DM.…”