Norms and equivalences for MoCA-30, MoCA-22, and MMSE in the oldest-old

Abstract

Background Cognitive screening is important for the oldest-old (age 90 +). This age group is the fastest growing and has the highest risk of dementia. However, norms and score equivalence for screening tests are lacking for this group. Aims To provide norms and score equivalence for commonly used cognitive screening tests for the oldest-old. Methods Data on 157 participants of the Center for Healthy Aging Longevity Study aged 90 + were analyzed. First, we derived norms for (1) subtests and cognitive domains of the in-person Montreal Cognitive Assessment having a maximum score of 30 (MoCA-30) and (2) the total MoCA-22 score, obtained from the in-person MoCA-30 by summing the subtests that do not require visual input to a maximum score of 22. These norms were derived from 124 participants with a Mini-Mental State Examination (MMSE) ≥ 27. Second, we derived score equivalences for MMSE to MoCA-30 and MoCA-22, and MoCA-30 to MoCA-22 using equipercentile equating method with log-linear smoothing, based on all 157 participants. Results MoCA-22 total score norms are: mean = 18.3(standard deviation = 2.2). An MMSE score of 27 is equivalent to a MoCA-30 score of 22 and a MoCA-22 score of 16. Discussion and conclusions Subtest, domain and MoCA-22 norms will aid in evaluation of the oldest-old who cannot complete the MoCA-30 or are tested over the phone. The equivalences of the three cognitive tests (MMSE, MoCA-30, MoCA-22) in the oldest-old will facilitate continuity of cognitive tracking of individuals tested with different tests over time and comparison of the studies that use different cognitive tests.

Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends

“…Cognitive function was measured using the 30-point Mini-Mental State Examination (MMSE) ( 43 ) among 68 couples, and the MMSE conversion equivalency score ( 44 , 45 ) was used for this analysis for the remaining 41 couples who completed the 30-point Montreal Cognitive Assessment (MoCA-30) ( 46 ). The MMSE is designed for clinician assessment of 11 cognitive domains spanning aspects of orientation, working memory, language, delayed recall, attention, and comprehension.…”

“…The resulting variable for cognitive function in this sample was a unified score from the MMSE/MMSE conversion scale. Although there are differences in the emphasis on domains measured by the MoCA vs. the MMSE, both scales are widely used and it is often necessary to convert scores from one scale to the other ( 44 , 45 ).…”

Study of the value of homocysteine levels in predicting cognitive dysfunction in patients after acute carbon monoxide poisoning

“…An MMSE score < 27, a cut-off point that differentiates normal cognition from mild cognitive impairment and dementia [ 10 – 12 ], was considered to indicate cognitive impairment.…”

Cognitive Outcomes in the Pragmatic Investigation of optimaL Oxygen Targets (CO-PILOT) trial: protocol and statistical analysis plan

“…Neuropsychological research coordinators who conduct all cognitive and functional outcomes assessments are blinded to the participants’ study arm and are overseen by an expert neuropsychologist (JCJ) with extensive prior experience in the assessment of outcomes in survivors of critical illness for both research27 and clinical purposes. All data are stored and managed within the REDCap secure web platform 28 29…”

“…28 29 Outcomes The primary outcome for the CO-PILOT ancillary study is the telephone version of the Montreal Cognitive Assessment (T-MoCA), which is identical in form to the MoCA-Blind. [28][29][30][31][32][33] The T-MoCA consists of a wide array of questions that sample a variety of cognitive domains (attention, language, abstraction, delayed memory and orientation) without containing the questions requiring visual assessment or pen and paper that are present in the original MoCA. This allows for its use in remote assessments and among patients with visual impairment.…”