Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis

Ciesielska, Natalia; Sokołowski, Remigiusz; Mazur, Ewelina; Podhorecka, Marta; Polak-Szabela, Anna; Kędziora–Kornatowska, Kornelia

doi:10.12740/pp/45368

Cited by 459 publications

(359 citation statements)

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“…This is in line with the conclusion and findings of recent reviews that thresholds lower than 26 are likely to be more useful for optimal diagnostic accuracy [9, 18, 25, 43]. …”

Section: Discussionsupporting

confidence: 91%

“…Thirdly, many other studies observed the same or close cutoff scores between 22 and 24 points for MCI in different languages, countries, and cohorts [3, 18, 20, 22, 23, 26, 33, 43]. This is in line with the conclusion and findings of recent reviews that thresholds lower than 26 are likely to be more useful for optimal diagnostic accuracy [9, 18, 25, 43].…”

Section: Discussionsupporting

confidence: 84%

“…We hope that we contributed to an ongoing international discussion to lower the cutoff from the originally recommended score of 26 points to the approximately 23–24 points found in our study and other studies [9, 18, 25, 43]. We also present reference values of the Czech MoCA-CZ stratified by age and education influencing total scores.…”

Section: Discussionmentioning

confidence: 71%

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Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons

Bartoš

Fayette

2018

Dement Geriatr Cogn Disord

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Background: The Czech version of the Montreal Cognitive Assessment (MoCA-CZ) and delayed recall of 5 words have not been validated in patients with mild cognitive impairment (MCI) due to Alzheimer disease (AD) and compared to norms of a large population. Method: The MoCA-CZ was administered to 1,600 elderly individuals in 2 groups consisting of 48 patients with MCI due to AD (AD-MCI) and 1,552 normal elderly adults. Results: MoCA-CZ scores were significantly lower in the AD-MCI patients than in the normal elderly (21 ± 4 vs. 26 ± 3 points; p = 0.03). Under the recommended cutoff score of ≤25, the MoCA-CZ demonstrated an excellent sensitivity of 94% but a low specificity of 62%. When the score was reduced to ≤24, the MoCA-CZ showed an optimal sensitivity of 87% for AD-MCI and a specificity of 72%. Normal elderly persons should recall at least 2 words after delay (sensitivity 80%, specificity 74%). Several cutoff points were derived from normative data stratified by age and education. Conclusions: The cutoff for AD-MCI and stratified norms are available for the MoCA total score and delayed recall of the Czech version. The cut-off scores of the MoCA-CZ, sensitivity, and specificity are lower than in the original study.

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“…This is in line with the conclusion and findings of recent reviews that thresholds lower than 26 are likely to be more useful for optimal diagnostic accuracy [9, 18, 25, 43]. …”

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

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Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons

Bartoš

Fayette

2018

Dement Geriatr Cogn Disord

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“…Several studies have reported on its ability to accurately identify individuals with impaired cognition relative to those who are non-cognitively impaired (NCI) [2–5]. In particular, recent studies have suggested that it is superior to the Mini Mental State Exam (MMSE) in terms of its diagnostic accuracy for identifying individuals with mild cognitive impairment (MCI) [3–5]. Cross-sectional normative performance of the MoCA in NCI older adults has also been reported by our group [6] and others [7].…”

Section: Introductionmentioning

confidence: 99%

Trajectory and variability characterization of the Montreal cognitive assessment in older adults

et al. 2017

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“…A meta-analysis of 20 studies conducted by Ciesielska et al [25] reported that a MoCA cutoff value of 25/30 correctly yielded a sensitivity of 80% and specificity of 81%. A meta-analysis of nine studies [26] evaluating the MoCA’s ability to discriminate aMCI from normal controls found that a cutoff value of 23/30 yielded a correct classification of 86% (95% CI 83–90%) with a sensitivity of 83% (95% CI 76–89%) and specificity of 88% (95% CI 84–92%), while the original cutoff value of 26/30, as suggested by Nasreddine et al [2], yielded correct classification of only 78% (95% CI 75–82%) with sensitivity of 94% (95% CI 91–97%) and specificity of 66% (95% CI 60–71%).…”

Section: Discussionmentioning

confidence: 99%

The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment

Freedman

Leach²,

Tartaglia

et al. 2018

Alz Res Therapy

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BackgroundA need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals.MethodsWe obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community.ResultsThe TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent.ConclusionsThe TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.

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Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis

Abstract: MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Cited by 459 publications

References 0 publications

Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons

Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons

Trajectory and variability characterization of the Montreal cognitive assessment in older adults

The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment

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