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Original Research Article

The Montreal Cognitive Assessment and the Mini-Mental State Examination as Screening Instruments for Cognitive Impairment: Item Analyses and Threshold Scores

Damian A.M.a · Jacobson S.A.b · Hentz J.G.c · Belden C.M.b · Shill H.A.b · Sabbagh M.N.b · Caviness J.N.c · Adler C.H.c

Author affiliations

aUniversity of Arizona College of Medicine Phoenix Campus, Phoenix, Ariz., bBanner Sun Health Research Institute, Sun City, Ariz., and cMayo Clinic, Scottsdale, Ariz., USA

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Dement Geriatr Cogn Disord 2011;31:126–131

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 26, 2010
Published online: January 29, 2011
Issue release date: March 2011

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

Abstract

Aims: To perform an item analysis of the Montreal Cognitive Assessment (MoCA) versus the Mini-Mental State Examination (MMSE) in the prediction of cognitive impairment, and to examine the characteristics of different MoCA threshold scores. Methods: 135 subjects enrolled in a longitudinal clinicopathologic study were administered the MoCA by a single physician and the MMSE by a trained research assistant. Subjects were classified as cognitively impaired or cognitively normal based on independent neuropsychological testing. Results: 89 subjects were found to be cognitively normal, and 46 cognitively impaired (20 with dementia, 26 with mild cognitive impairment). The MoCA was superior in both sensitivity and specificity to the MMSE, although not all MoCA tasks were of equal predictive value. A MoCA threshold score of 26 had a sensitivity of 98% and a specificity of 52% in this population. In a population with a 20% prevalence of cognitive impairment, a threshold of 24 was optimal (negative predictive value 96%, positive predictive value 47%). Conclusion: This analysis suggests the potential for creating an abbreviated MoCA. For screening in primary care, the MoCA threshold of 26 appears optimal. For testing in a memory disorders clinic, a lower threshold has better predictive value.

© 2011 S. Karger AG, Basel


References

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    External Resources
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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 26, 2010
Published online: January 29, 2011
Issue release date: March 2011

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM


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