Comparison of the Diagnostic Accuracy of Neuropsychological Tests in Differentiating Alzheimer's Disease from Mild Cognitive Impairment: Can the Montreal Cognitive Assessment Be Better than the Cambridge Cognitive Examination

Abstract

Objective: Considering the lack of studies on measures that increase the diagnostic distinction between Alzheimer's disease (AD) and mild cognitive impairment (MCI) and on the role of the Cambridge Cognitive Examination (CAMCOG) in this, our study aims to compare the utility of the CAMCOG, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in helping to differentiate AD from MCI in elderly people with >4 years of schooling. Method: A total of 136 elderly subjects - 39 normal controls as well as 52 AD patients and 45 MCI patients treated at the Institute of Geriatrics and Gerontology, Porto Alegre, Brazil - were assessed using the MMSE, CAMCOG, clock drawing test (CDT), verbal fluency test (VF), Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire. Results: The results obtained by means of a receiver operating characteristic curve showed that the MoCA is a better screening test for differentiating elderly subjects with AD from those with MCI than the CAMCOG and MMSE as well as other tests such as the CDT and VF. Conclusion: The MoCA, more than the CAMCOG and the other tests, was shown to be able to differentiate AD from MCI, although, as Roalf et al. [Alzheimers Dement 2013;9:529-537] pointed out, further studies might lead to measures that will improve this differentiation.

Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

“…These findings differ from other previous studies that showed that MoCA could be a valid and reliable tool for screening of MCI in the Brazilian population 18,25 . In those studies, MoCA reached good accuracy for the identification of subjects with MCI.…”

“…The cut-off scores and accuracy observed in our sample were very similar to those observed in other studies using theses scales in the general Brazilian population 15,16,18,25 . The practical importance to study alternative short global scales to evaluate cognition in patients with PD is due to the general impression that the MMSE, the most commonly used instrument worldwide to evaluate cognition in patients with PD, does not provide sufficient accuracy for the detection of dementia or MCI in these patients 2,10 .…”

“…The original validation data suggested that the use of a MoCA cut-off score of 26 was ideal to detect MCI. Specific studies in the Brazilian population showed that the use of the cut-off of scores of 24 or 25 points had the greater accuracy for the identification of MCI, and that the cut-off scores of 21 or 22 was ideal for the identification of dementia 25 . Studies in patients with PD showed similar findings with some small variations 10, 12,26 .…”

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

“…Two studies (N=168) validated the MoCA differentiating MCI from controls in Brazil [58,59] both reporting a cut off of 25 with adequate sensitivity and specificity. One study [60] (N=68) validated the MoCA-Chile suggesting a cut off of 24 in an educated sample.…”

Prevalência de comprometimento cognitivo em adultos e idosos indígenas

“…A pontuação varia de zero (capaz) a três (incapaz) para cada item e, quanto maior a pontuação final, maior será a dependência do paciente. Nota de corte 3 para comprometimento funcional (Sousa et al, 2011;Correa et al, 2014); e 5 para incapacidade funcional (Herrera et al, 2002;Laks et al, 2005;2007;Hoffmann et al, 2010;Damin, 2011;Pavarini, 2011;Nascimento et al, 2012;Martinelli et al, 2014;Damin et al, 2015) (Anexo 9).…”