Usefulness of the Polish versions of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination as screening instruments for the detection of mild neurocognitive disorder

Abstract

Introduction. Screening tests are a key step in the diagnosis of dementia and should therefore be highly sensitive to the detection of mild neurocognitive disorders (NCD). The Mini Mental State Examination (MMSE) is the most commonly used screening method. The Montreal Cognitive Assessment (MoCA) is a newer and less well-known screening tool, which has none of the limitations of the MMSE. Aim. The aim of this study was to analyse the reliability of the Polish versions of MoCA 7.2 vs MMSE in the detection of mild NCD among people aged over 60. Material and methods. The study was carried out at the Department and Clinic of Geriatrics from September 2014 to March 2017. The study included 281 participants, 91 of whom were assigned to the group without NCD. The other 190 had been diagnosed with mild NCD.Results. In the analysis of the ROC curve of the MoCA 7.2 results, the AUC was 0.925 (p < 0.001). The optimal cut-off point for mild NCD was 23/24 points, with sensitivity and specificity of 83.2% and 79.1%. In the ROC curve of MMSE results, the AUC was 0.847 (p < 0.001). The optimal cut-off point for mild NCD was 27/28 points, with sensitivity and specificity of 75.8% and 66.7%. The difference between AUC MoCA 7.2 and MMSE was 0.078 (p = 0.036).Conclusions. MoCA 7.2 detects mild NCD with more sensitivity than MMSE. We recommend using the cut-off point for MoCA of 23/24 points, because this is characterised by a higher sensitivity than the previously recommended cut-off point of 25/26 points. For the MMSE, the recommended cut-off point should be 27/28, which gives greater diagnostic accuracy than the previously recommended 25/26 points.

Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment

“…A total of 55 studies ( Fujiwara et al, 2010 ; Lu et al, 2011 ; Ahmed et al, 2012 ; Larner, 2012 ; Yu et al, 2012 ; Dong et al, 2013 ; Freitas et al, 2013 ; Memória et al, 2013 ; Roalf et al, 2013 ; Cummings-Vaughn et al, 2014 ; Goldstein et al, 2014 ; Kaya et al, 2014 ; Malek-Ahmadi et al, 2014 ; Yeung et al, 2014 ; Zhou et al, 2014 ; Chu et al, 2015 ; Julayanont et al, 2015 ; Ng et al, 2015 ; Trzepacz et al, 2015 ; Mellor et al, 2016 ; O’Caoimh et al, 2016 ; Tsai et al, 2016 ; Cecato et al, 2017 ; Clarnette et al, 2017 ; Janelidze et al, 2017 ; Bartos and Fayette, 2018 ; Chiu et al, 2018 ; Lee et al, 2018 ; Li et al, 2018 ; Cesar et al, 2019 ; Delgado et al, 2019 ; Rossetti et al, 2019 ; Townley et al, 2019 ; Wang et al, 2019 ; Pinto et al, 2019b ; Aycicek et al, 2020 ; Bello-Lepe et al, 2020 ; Dautzenberg et al, 2020 ; Freud et al, 2020 ; Senda et al, 2020 ; Serrano et al, 2020 ; Sokołowska et al, 2020 ; Thomann et al, 2020 ; González et al, 2021 ; Hemrungrojn et al, 2021 ; Masika et al, 2021 ; Rashedi et al, 2021 ; Rodríguez-Salgado et al, 2021 ; Yan et al, 2021 ; Pan et al, 2022 ; Paterson et al, 2022 ) were included in this meta-analysis from which 40 were used in the AUC analysis and 45 were used in the analysis of mean differences. Thirty-one of the included studies were used in both the AUC and mean difference analyses.…”

Accuracy of the Montreal Cognitive Assessment tool for detecting mild cognitive impairment: A systematic review and meta‐analysis

“…The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 15 study flow diagram is shown in Figure S1 in Appendix I. From 2683 citations, 334 were selected for full‐text screening, and 13 studies were included 9,16–27 …”

Neuroplasticity vs. cognitive prediction models in acute ischaemic stroke: limitations must be remembered

“…There are also potential limitations reported in the use of the Montreal Cognitive Assessment (MoCA) as a cognitive impairment screening tool [7], where the correspondence between individual tests and their assumed cognitive domains is not robust, reflecting at least in part a current lack of consensus as to how core cognitive constructs are defined and as to which subcomponents can be subsumed under different cognitive domains [7]. These limitations among the correlations cause the cut-off scores published in the literature to diverge, and do not allow accurate prediction of cognitive impairment [8].…”