Optimal Cutoff Scores for Dementia and Mild Cognitive Impairment of the Montreal Cognitive Assessment among Elderly and Oldest-Old Chinese Population

Tan, Jiping; Li, Nan; Gao, Jing; Wang, Luning; Zhao, Yiming; Yu, Bao-cheng; Du, Wei; Zhang, Wenjun; Cui, Lianqi; Wang, Qingsong; Li, Jianjun; Yang, Jinsheng; Yu, Jian-min; Xiang-nan, Xia; Zhou, Peiyi

doi:10.3233/jad-141278

Cited by 121 publications

(111 citation statements)

References 12 publications

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“…Consistent with previous findings, older age was associated with lower scores [11][12][13][14][15][16][17][18][31][32][33][34][35]. We found a 1.0-point difference between the youngest (65-75) and oldest (75-85) groups; other studies have reported a difference of 0.6-2.4 points between similar age groups [13,[15][16][17]31].…”

Section: Discussionsupporting

confidence: 91%

“…We found a 1.0-point difference between the youngest (65-75) and oldest (75-85) groups; other studies have reported a difference of 0.6-2.4 points between similar age groups [13,[15][16][17]31]. Lower level of education was significantly associated with lower scores, correlating with results from other studies [11][12][13][14][15][16][17][18][31][32][33][34][35]. The difference in mean score was 1.4 points between the least and highest educated groups, in agreement with the original suggested method of adding an extra point for low education (≤12 years).…”

Section: Discussionsupporting

confidence: 87%

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[P3–284]: The Montreal Cognitive Assessment: Normative Data From a Large Swedish Population‐based Cohort

Borland¹,

Nägga

Nilsson

et al. 2017

Alzheimer's & Dementia

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Abstract.Background: The Montreal Cognitive Assessment (MoCA) has a high sensitivity for detecting cognitive dysfunction. Swedish normative data does not exist and international norms are often derived from populations where cognitive impairment has not been screened for and not been thoroughly assessed to exclude subjects with dementia or mild cognitive impairment. Objective: To establish norms for MoCA and develop a regression-based norm calculator based on a large, well-examined cohort. Methods: MoCA was administered on 860 randomly selected elderly people from a population-based cohort from the EPIC study. Cognitive dysfunction was screened for and further assessed at a memory clinic. After excluding cognitively impaired participants, normative data was derived from 758 people, aged 65-85. Results: MoCA cut-offs (-1 to -2 standard deviations) for cognitive impairment ranged from <25 to <21 for the lowest educated and <26 to <24 for the highest educated, depending on age group. Significant predictors for MoCA score were age, sex and level of education. Conclusion: We present detailed normative MoCA data and cut-offs according to the DSM-5 criteria for cognitive impairment based on a large population-based cohort of elderly individuals, screened and thoroughly investigated to rule out cognitive impairment. Level of education, sex, and age should be taken in account when evaluating MoCA score, which is facilitated by our online regression-based calculator that provide percentile and z-score for a subject's MoCA score.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

[P3–284]: The Montreal Cognitive Assessment: Normative Data From a Large Swedish Population‐based Cohort

Borland¹,

Nägga

Nilsson

et al. 2017

Alzheimer's & Dementia

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“…The MoCA, developed and validated by Nasreddine et al [13], is a brief and potentially useful screening tool with high sensitivity and specificity for detecting MCI in persons performing in the normal range on the Mini-Mental State Examination (MMSE). It has been translated into 36 languages and additional alternative forms, yet only a small number have been validated and nearly all versions lack population-based data of individuals aged 80-plus [14]. For instance, the norms and cut-off scores for MCI and dementia of the MoCA are different among five Chinese versions [14] and the cut-off of 26 (+1 for <12 years education; recommended in the original study), has been suggested on many forms without validation.…”

Section: Introductionmentioning

confidence: 99%

“…It has been translated into 36 languages and additional alternative forms, yet only a small number have been validated and nearly all versions lack population-based data of individuals aged 80-plus [14]. For instance, the norms and cut-off scores for MCI and dementia of the MoCA are different among five Chinese versions [14] and the cut-off of 26 (+1 for <12 years education; recommended in the original study), has been suggested on many forms without validation.…”

Section: Introductionmentioning

confidence: 99%

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

O’Driscoll

Shaikh

2017

JAD

137

121

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The MoCA is widely used to screen for mild cognitive impairment. While there are many available versions, the cross cultural validity of the assessment has not been explored sufficiently.We aimed to interrogate the validity of the MoCA in a cross-cultural context: in differentiating mild cognitive impairment (MCI) from normal controls (NC); and identifying cut-offs and adjustments for age and education where possible. This review sourced a wide range of studies including case-control studies. In addition, we report findings for differentiating dementias from NC and MCI from dementias, however, these were not considered to be an appropriate use of the MoCA.The subject of the review assumes heterogeneity and therefore meta-analysis/es was not conducted. Quality ratings, forest plots of validated studies (sensitivity and specificity) with covariates (suggested cut-offs, age, education and country) and summary received operating characteristic curve (sROC) are presented.The results showed a wide range in suggested cutoffs for MCI cross culturally, with variability in levels of sensitivity and specificity ranging from low to high. Poor methodological rigour appears to have affected reported accuracy and validity of the MoCA.The review highlights the necessity for cross cultural considerations when using the MoCA, and recognizing it as a screen and not a diagnostic tool. Appropriate cutoffs and point adjustments for education are suggested.2

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“…The cutoff point of <25, <24, <23 in MoCA scores [20] must be taken under the reserve that cutoff points must be established appropriate to culturally context and maybe that the bonus point given to those having under 12 years of schooling is just not enough to homogenize the subjects capacity of completing the questionnaire [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Postoperative Cognitive Dysfunction Incidence and Involved Neurocognitive Functions in Patients with Cardiac and Noncardiac Surgery Under General Anesthesia

Sircuța

Lucza²,

Mihaly

et al. 2017

Acta Medica Marisiensis

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Objective: To analyse postoperative cognitive dysfunction's (POCD) incidence and cognitive areas involved, in patients with cardiac and general surgery. Material and Methods: Prospective observational study on 130 patients undergoing general or heart surgery on cardiopulmonary bypass, under general anesthesia. Two groups, 65 members each. Group A had a heart surgery and group B a noncardiac surgery. The same type of anesthetic drugs were used. All patients completed the Montreal Cognitive Assesment (MoCA) questionnaire: preoperative, 24 hours after stopping any medicine acting on central nervous system and 7 days postoperative. We compared the MoCA scores obtained on different cognitive domains in this moments for each group of patients, for neurocognitive functions: visuo-spatial executive, naming, attention, verbal fluency, abstraction, recall, orientation, final score. We compared the scores between the two groups at 24 hours and 7 days postoperatively for the same domains. Results: POCD was found at 24 hours testing in both groups. At 7 days postoperatively POCD was not found in any of the groups. There was no statistically significant difference in total final score between two groups at 24 hours nor at 7 days postoperative testing. There are significant differences between the two groups, with lower score in cardiac group in 5 of 7 fields at 24 hours testing, with the persistence of difference in 2 of 7 fields at 7 days. Conclusions: Overall POCD was present at 24 hours but was not found at 7 days testing for none of the groups. POCD is present in some neurocognitive domains and this depends on surgery type.

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Optimal Cutoff Scores for Dementia and Mild Cognitive Impairment of the Montreal Cognitive Assessment among Elderly and Oldest-Old Chinese Population

Abstract: Compared with the MMSE, the MoCA-P is significantly better for detecting MCI in the elderly, particularly in the oldest old population, and it also displays more effectiveness in detecting dementia.

Cited by 121 publications

References 12 publications

[P3–284]: The Montreal Cognitive Assessment: Normative Data From a Large Swedish Population‐based Cohort

[P3–284]: The Montreal Cognitive Assessment: Normative Data From a Large Swedish Population‐based Cohort

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

Evaluation of Early Postoperative Cognitive Dysfunction Incidence and Involved Neurocognitive Functions in Patients with Cardiac and Noncardiac Surgery Under General Anesthesia

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