Identifying an Optimal Cutoff of the Montreal Cognitive Assessment to Predict Amyloid-PET Positivity in a Referral Memory Clinic

2019 ◽  
Vol 33 (3) ◽  
pp. 194-199
Author(s):  
Anil K. Nair ◽  
Srinath Ramaswamy ◽  
Krystal Kan ◽  
Shreya Nair
Keyword(s):  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Amyloid Pet ◽  
Memory Clinic ◽  
Optimal Cutoff

Short Montreal Cognitive Assessment

2016 ◽  
Vol 30 (2) ◽  
pp. 104-108 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Computerized Adaptive Testing ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Subjective Memory ◽  
Index Study ◽  
Diagnosis Of Dementia

The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.

Evaluating the Beijing Version of Montreal Cognitive Assessment for Identification of Cognitive Impairment in Monolingual Chinese American Older Adults

2021 ◽  
pp. 089198872110361
Author(s):  
Yue Hong ◽  
Xiaoyi Zeng ◽  
Carolyn W. Zhu ◽  
Judith Neugroschl ◽  
Amy Aloysi ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Demographic Variables ◽  
Chinese Version ◽  
Montreal Cognitive Assessment ◽  
Optimal Cutoff ◽  
Cutoff Scores ◽  
Normal Cognition ◽  
The U.S

Objective: This study aims to evaluate the performance of a Chinese version of the Montreal Cognitive Assessment (MoCA) as a screener to detect mild cognitive impairment (MCI) and dementia from normal cognition in the monolingual Chinese-speaking immigrant population. Method: A cohort of 176 Chinese-speaking older adults from the National Alzheimer’s Coordinating Center Uniform Data Set is used for analysis. We explore the impact of demographic variables on MoCA performance and calculate the optimal cutoffs for the detection of MCI and dementia from normal cognition with appropriate demographic adjustment. Results: MoCA performance is predicted by age and education independent of clinical diagnoses, but not by sex, years of living in the U.S., or primary Chinese dialect spoken (i.e., Mandarin vs. Cantonese). With adjustment and stratification for education and age, we identify optimal cutoff scores to detect MCI and dementia, respectively, in this population. These optimal cutoff scores are different from the established scores for non-Chinese-speaking populations residing in the U.S. Conclusions: Our findings suggest that the Chinese version of MoCA is a valid screener to detect cognitive decline in older Chinese-speaking immigrants in the U.S. They also highlight the need for population-based cutoff scores with appropriate considerations for demographic variables.

Screening utility of the Montreal Cognitive Assessment (MoCA): in place of – or as well as – the MMSE?

2011 ◽  
Vol 24 (3) ◽  
pp. 391-396 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
The Elderly ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Diagnostic Utility ◽  
Memory Clinic ◽  
Index Study ◽  
In Series

ABSTRACTBackground: This aim of this study was to assess the clinical utility of the Montreal Cognitive Assessment (MoCA) as a screening instrument for cognitive impairment in patients referred to a memory clinic, alone and in combination with the Mini-Mental State Examination (MMSE).Methods: This was a pragmatic prospective study of consecutive referrals attending a memory clinic (n = 150) over an 18-month period. Patients were diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) and mild cognitive impairment (MCI; cognitive impairment prevalence = 43%) independent of MoCA test scores.Results: MoCA proved acceptable to patients and was quick and easy to use. Using the cut-offs for MoCA and MMSE specified in the index paper (≥26/30), MoCA was more sensitive than MMSE (0.97 vs 0.65) but less specific (0.60 vs 0.89), with better diagnostic accuracy (area under Receiver Operating Characteristic curve 0.91 vs 0.83). Downward adjustment of the MoCA cut-off to ≥20/30 maximized test accuracy and improved specificity (0.95) for some loss of sensitivity (0.63). Combining MoCA with the MMSE – either in series or in parallel – did not improve diagnostic utility above that with either test alone.Conclusions: In a memory clinic population, MoCA proved sensitive for the diagnosis of cognitive impairment. Use of a cut-off lower than that specified in the index study may be required to improve overall test accuracy and specificity for some loss of sensitivity in populations with a high prior probability of cognitive impairment. Combining the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) with the MMSE did not improve diagnostic utility.

The Montreal Cognitive Assessment is superior to the Mini–Mental State Examination in detecting patients at higher risk of dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1749-1755 ◽  
Author(s):  
YanHong Dong ◽  
Wah Yean Lee ◽  
Nur Adilah Basri ◽  
Simon Lowes Collinson ◽  
Reshma A. Merchant ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Discriminant Validity ◽  
Mini Mental State Examination ◽  
Montreal Cognitive Assessment ◽  
Memory Clinic ◽  
Clinic Setting ◽  
Incident Dementia ◽  
State Examination

ABSTRACTBackground: To examine the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting patients with cognitive impairment at higher risk for dementia at a memory clinic setting.Methods: Memory clinic patients were administered the MoCA, MMSE, and a comprehensive formal neuropsychological battery. Mild cognitive impairment (MCI) subtypes were dichotomized into two groups: single domain–MCI (sd–MCI) and multiple domain-MCI (md–MCI). Area under the receiver operating characteristic curve (ROC) analysis was used to compare the discriminatory ability of the MoCA and the MMSE.Results: Two hundred thirty patients were recruited, of which 136 (59.1%) were diagnosed with dementia, 61 (26.5%) with MCI, and 33 (14.3%) with no cognitive impairment (NCI). The majority of MCI patients had md–MCI (n = 36, 59%). The MoCA had significantly larger AUCs than the MMSE in discriminating md–MCI from the lower risk group for incident dementia (NCI and sd–MCI) [MoCA 0.92 (95% CI, 0.86–0.98) vs. MMSE 0.84 (95% CI, 0.75–0.92), p = 0.02). At their optimal cut-off points, the MoCA (19/20) remained superior to the MMSE (23/24) in detecting md–MCI [sensitivity: 0.83 vs. 0.72; specificity: 0.86 vs. 0.83; PPV: 0.79 vs. 0.72; NPV: 0.89 vs. 0.83; correctly classified: 85.1% vs. 78.7%].Conclusion: The MoCA is superior to the MMSE in the detection of patients with cognitive impairment at higher risk for incident dementia at a memory clinic setting.

scholarly journals Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

2016 ◽  
Vol 43 (4) ◽  
pp. 513-517 ◽  
Author(s):  
Mervin Blair ◽  
Kristy Coleman ◽  
Sarah Jesso ◽  
Véronique Desbeaumes Jodoin ◽  
Kathy Smolewska ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depressive Symptomatology ◽  
Negative Impact ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
The Impact

AbstractObjective:The Montreal Cognitive Assessment (MoCA) is a general cognitive screening tool that has shown sensitivity in detecting mild levels of cognitive impairment in various clinical populations. Although mood dysfunction is common in referrals to memory clinics, the influence of mood on the MoCA has to date been largely unexplored.Method:In this study, we examined the impact of mood dysfunction on the MoCA using a memory clinic sample of individuals with depressive symptoms who did not meet criteria for a neurodegenerative disease.Results:Half of the group with depressive symptoms scored below the MoCA-suggested cutoff for cognitive impairment. As a group, they scored below healthy controls, but above individuals with Alzheimer’s disease and frontotemporal dementia. A MoCA subtask analysis revealed a pattern of executive/attentional dysfunction in those with depressive symptoms.Conclusions:This observed negative impact of depressive symptomatology on the MoCA has interpretative implications for its utility as a cognitive screening tool in a memory clinic setting.

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