![]() Calculation and literacy tests: A person may have to work out simple sums.A drawing test: A professional may ask a person to replicate a drawing, such as a clock face that shows a specific time.They may later have to recall what objects were present in the illustration. A visual association test (VAT): During the VAT, a person will identify objects in an illustration - for example, a monkey holding an umbrella - and explain how they interact.A memory questionnaire: This section assesses a person’s ability to recall personal and nonpersonal memories.The test contains different sections that examine different aspects of cognitive function. It is also possible to adjust the scores for people with lower levels of education. There are also versions of the test for those who are blind or hard of hearing. MoCA scores are translatable to the MMSE to facilitate comparison.The MoCA test, which consists of a 30-point assessment on one side of an A4 page, takes about 10 minutes to complete.Ī person can do the test on paper or online via an app. Functional assessment can help exclude dementia cases. A cutoff of ≥ 17 on the MoCA may help capture early and late MCI cases depending on the level of sensitivity desired, ≥ 18 or 19 could be used. ![]() Mean FAQ scores were significantly higher and a greater proportion had abnormal FAQ scores in dementia than MCI and HC.ĬONCLUSIONS: MoCA and MMSE were more similar for dementia cases, but MoCA distributes MCI cases across a broader score range with less ceiling effect. The core and orientation domains in both tests best distinguished HC from MCI groups, whereas comprehension/executive function and attention/calculation were not helpful. ROC analysis found MoCA ≥ 17 as the cutoff between MCI and dementia that emphasized high sensitivity (92.3%) to capture MCI cases. Equi-percentile equating showed a MoCA score of 18 was equivalent to MMSE of 24. MoCA and MMSE scores correlated most for dementia (r = 0.86 versus MCI r = 0.60 HC r = 0.43). The ceiling effect (28-30 points) for MCI and HC was less using MoCA (18.1%) versus MMSE (71.4%). Most MCI cases scored ≥ 17 on MoCA (96.3%) and ≥ 24 on MMSE (98.3%). RESULTS: Most dementia cases scored abnormally, while MCI and HC score distributions overlapped on each test. Receiver Operating Characteristic (ROC) analyses evaluated lower cutoff scores for capturing the most MCI cases. Equi-percentile equating produced a translation grid for MoCA against MMSE scores. Functional Activities Questionnaire (FAQ) was evaluated as a strategy to separate dementia from MCI. Stepwise variable selection in logistic regression evaluated relative value of four test domains for separating MCI from HC. METHODS: For this cross-sectional study, we analyzed 219 healthy control (HC), 299 MCI, and 100 Alzheimer's disease (AD) dementia cases from the Alzheimer's Disease Neuroimaging Initiative (ADNI)-GO/2 database to evaluate MMSE and MoCA score distributions and select MoCA values to capture early and late MCI cases. Clinicians need to better understand the relationship between MoCA and MMSE scores. BACKGROUND: The Montreal Cognitive Assessment (MoCA) was developed to enable earlier detection of mild cognitive impairment (MCI) relative to familiar multi-domain tests like the Mini-Mental State Exam (MMSE).
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