Optimal Cutoff Scores for Dementia and Mild Cognitive Impairment in the Brazilian Version of the Montreal Cognitive Assessment among the Elderly

Pinto, Tiago Coimbra Costa; Santos, Maria Aparecida dos; Machado, Leonardo; Bulgacov, Tatiana M; Rodrigues-Júnior, Antônio Luiz; Silva, Gabriela A.; Costa, María Lúcia Gurgel da; Ximenes, Rosana Christine Cavalcanti; Sougey, Éverton Botelho

doi:10.1159/000495562

Cited by 17 publications

(21 citation statements)

References 42 publications

(71 reference statements)

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“…is wide range of MoCA scores (i.e., 18-24) for uncertain MCI from this study reflects the wide range of MoCA cutoffs found previous studies that used certain validating criteria and ROC analysis [2][3][4][5][6][7][8][9][10][11][12]. Studies that used latent class analysis also found cutoffs within a similar range, for instance, 19-25 [27] and 19-23 [28].…”

Section: Discussionsupporting

confidence: 68%

“…e optimal cutoff score for screening mild cognitive impairment (MCI) in older adults has been widely explored in applying the Montreal Cognitive Assessment (MoCA), which is a tool designed exclusively for screening MCI in older adults [1]. Nevertheless, different from the original cutoff score of 24, various cutoffs have been identified, ranging from 18/19 to 26/27 across different cultures [2][3][4][5][6]. A recent meta-analysis of studies with strictly verifiable criteria of MCI suggested that the optimal cutoff was 23 based on balanced sensitivity (the probability of true positives) and specificity (the probability of true negatives) as well as samples of different language, cultural, and educational background.…”

Section: Introductionmentioning

confidence: 99%

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Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal

Yang

Dong

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Cutoff scores of the Montreal cognitive assessment (MoCA) for screening mild cognitive impairment in older adults differ across the world and within the Chinese culture. It is argued that to seek a cutoff score is essential to classify test participants. It was unknown how taking a classifying approach might reveal the cutoff score for identifying mildly cognitively impaired older adults. Methods. Participants, selected from 13 communities in Wuhan, China, were tested with the Chinese version of MoCA and rated with the Activities of Daily Living and the Clinical Dementia Rating scales. Mixture modeling was applied to the data with certain covariates and MoCA sum scores as the outcome of the latent class. Models with different numbers of classes were compared in terms of information criteria, likelihood ratio test, entropy, and interpretability. Results. A 3-class model (normal, mildly impaired, and severely impaired) was found to fit the data best. The normal class averaged a MoCA score of 24, while the severely impaired class averaged a score below 18. For those cases with MoCA scores above 18 and below 24, it is not certain if they are in the normal or the severely impaired classes. Conclusion. Latent variable classification modeling provides another option to identify MCI in older adults. Some categorically different cases of MCI cannot be captured with any single MoCA sum score. A range of 18–24 MoCA scores might serve as a better screening criterion of MCI. Older adults who scored within this gray zone should be monitored for potential interventions.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal

Yang

Dong

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…MoCA scores range between 0 and 30; a score of ≥ 26 reflects a lack of cognitive difficulties. The cut‐off scores of 22 points are recommended in the case of individuals aged 70+ (Pinto et al., 2019). Younger subjects with scores < 26 and older subjects with scores < 21 were not taken into account in the study. Vocabulary subtest of the Polish version of Wechsler Adults Intelligence Scale (WAIS‐R PL; Brzeziński et al., 2004).…”

Section: Methodsmentioning

confidence: 99%

“…MoCA scores range between 0 and 30; a score of ≥ 26 reflects a lack of cognitive difficulties. The cut-off scores of 22 points are recommended in the case of individuals aged 70+(Pinto et al, 2019).ParticipantsAn invitation to participate in the study was posted on a local academic institution's website. The trials were carried out by two clinical psychologists.…”

mentioning

confidence: 99%

Interpretation of familiar metaphors and proverbs by Polish people in middle and late adulthood

Szepietowska

Filipiak

2021

Intl J Lang & Comm Disor

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Background:The ability to understand figurative language, including metaphors and proverbs, decreases with age, although the phenomenon is not universal. Cognitive capacities and education play an important role in the competence connected with figurative language use and comprehension in people during the second half of life.Aims: To identify possible similarities and differences in task performance by subjects representing middle adulthood (40-49 and 50-59 years old) and late adulthood (60-69 and 70-92 years old). Additionally, the analyses took into account factors significantly affecting the results, that is, tasks type (metaphors versus proverbs), the way the answer is given (open-ended versus multiple choice) and types of answers (abstract and concrete). This study also aimed to identify some cognitive correlates of task completion. Methods & Procedures: A total of 86 Caucasian subjects, aged 40-92 years, participated in this study (M whole group = 62.37, SD = 15.53); the group included 20 subjects aged 40-49 years (M age = 45.4; SD = 3.05), 20 aged 50-59 years (M age = 55.50; SD = 2.64), 20 aged 60-69 years (M age = 64.40; SD = 2.78), and 26 aged 70-92 years (M age = 79.15; SD = 6.27). A total of 20 well-known Polish metaphors and 20 popular Polish proverbs were used to assess the level of proverb and metaphor comprehension. The Montreal Cognitive Assessment Scale and Vocabulary subtest of the Polish version of WAIS-R were applied to assess the cognitive functions. Outcomes & Results:The results of the analyses suggest that there are differences as well as certain similarities between the groups. At 70+ years of age, the ability to explain and comprehend metaphors and proverbs decreases when compared with younger adults. In the 70+ group, the ability to grasp the meaning of both metaphors and proverbs is similar, unlike in the younger groups which present a better ability to explain and comprehend metaphors than proverbs. The conditions related to the types of tasks, that is, spontaneous interpretation and choice of responses, do not affect scores of the oldest subjects. Conclusions: The analysis of response types, that is, abstract versus concrete, shows that, compared with younger groups, people aged 70+ years tend to less

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“…One of the most widely used brief assessment instruments is the Mini-Mental State Examination (MMSE) [14]. However, recent studies have found that it is not as sensitive in assessing MCI [5,[15][16][17][18][19] and early dementia as the Montreal Cognitive Assessment (MoCA), for which studies identify greater sensitivity and specificity to detect the stages mentioned above [13,[20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Impact of Educational Level on Versions (Basic and Complete) of the Montreal Cognitive Assessment

Díaz¹,

Arango²,

Parra³

et al. 2021

Dement Geriatr Cogn Disord

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Background: One of the most marked problems in the use of screening instruments for the diagnosis of dementia or cognitive impairment in the elderly is the influence of educational level on the results of psychometric tests. The Montreal Cognitive Assessment (MoCA) questionnaire is one of the most widely used dementia screening instruments internationally and with greater proven validity. There is a version of this instrument called MoCA “Basic” which was developed to reduce education bias. The aim of the study was to compare the psychometric characteristics of the MoCA, full versus basic, versions in older adults. Method: Participants (N = 214) completed both versions of the MoCA, and screening measures to corroborate their health status. Results: Internal consistency was satisfactory in both versions: MoCA full (0.79) and MoCA basic (0.76). The overall correlation between both tests was high (0.73). There was no relationship between the dimensions included in each version. Educational level and age explained 33.8% of the total variance in MoCA Full and 31.8% in MoCA Basic. Among educational levels, there are statistically significant differences in participants with <6 years of education. Conclusions: The results confirm that both versions are reliable instruments and also show that in both versions the educational level of <6 years of education continues to have an impact on performance. Therefore, it can be considered that the MoCA Basic version for the Ecuadorian population with <6 years of education continues to imply literacy competencies.

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Optimal Cutoff Scores for Dementia and Mild Cognitive Impairment in the Brazilian Version of the Montreal Cognitive Assessment among the Elderly

Cited by 17 publications

References 42 publications

Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal

Montreal Cognitive Assessment: Seeking a Single Cutoff Score May Not Be Optimal

Interpretation of familiar metaphors and proverbs by Polish people in middle and late adulthood

Impact of Educational Level on Versions (Basic and Complete) of the Montreal Cognitive Assessment

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