scholarly journals A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofang Jia ◽  
Zhihong Wang ◽  
Feifei Huang ◽  
Chang Su ◽  
Wenwen Du ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Ceiling Effect ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Relative Standard ◽  
State Examination

Abstract Background The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to detect mild cognitive impairment (MCI) in population-based epidemiologic studies. However, their comparison on which is best suited to assess cognition is scarce in samples from multiple regions of China. Methods We conducted a cross-sectional analysis of 4923 adults aged ≥55 years from the Community-based Cohort Study on Nervous System Diseases. Objective cognition was assessed by Chinese versions of MMSE and MoCA, and total score and subscores of cognitive domains were calculated for each. Education-specific cutoffs of total score were used to diagnose MCI. Demographic and health-related characteristics were collected by questionnaires. Correlation and agreement for MCI between MMSE and MoCA were analyzed; group differences in cognition were evaluated; and multiple logistic regression model was used to clarify risk factors for MCI. Results The overall MCI prevalence was 28.6% for MMSE and 36.2% for MoCA. MMSE had good correlation with MoCA (Spearman correlation coefficient = 0.8374, p < 0.0001) and moderate agreement for detecting MCI with Kappa value of 0.5973 (p < 0.0001). Ceiling effect for MCI was less frequent using MoCA versus MMSE according to the distribution of total score. Percentage of relative standard deviation, the measure of inter-individual variance, for MoCA (26.9%) was greater than for MMSE (19.0%) overall (p < 0.0001). Increasing age (MMSE: OR = 2.073 for ≥75 years; MoCA: OR = 1.869 for≥75 years), female (OR = 1.280 for MMSE; OR = 1.163 for MoCA), living in county town (OR = 1.386 and 1.862 for MMSE and MoCA, respectively) or village (OR = 2.579 and 2.721 for MMSE and MoCA, respectively), smoking (OR = 1.373 and 1.288 for MMSE and MoCA, respectively), hypertension (MMSE: OR = 1.278; MoCA: OR = 1.208) and depression (MMSE: OR = 1.465; MoCA: OR = 1.350) were independently associated with greater likelihood of MCI compared to corresponding reference group in both scales (all p < 0.05). Conclusions MoCA is a better measure of cognitive function due to lack of ceiling effect and with good detection of cognitive heterogeneity. MCI prevalence is higher using MoCA compared to MMSE. Both tools identify concordantly modifiable factors for MCI, which provide important evidence for establishing intervention measures.

Comparison between the accuracy of Montreal Cognitive Assessment and Mini-Mental State Examination in the detection of mild cognitive impairment

2021 ◽  
Author(s):  
Nayyereh Aminisani ◽  
Rasoul alimi ◽  
Ali Javadpour ◽  
Mohhamad Asghari-Jafarabadi ◽  
Mozhgan Jourian ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
The Impact ◽  
State Examination

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly?

2018 ◽  
Vol 31 (04) ◽  
pp. 491-504 ◽  
Author(s):  
Tiago C. C. Pinto ◽  
Leonardo Machado ◽  
Tatiana M. Bulgacov ◽  
Antônio L. Rodrigues-Júnior ◽  
Maria L. G. Costa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Montreal Cognitive Assessment ◽  
Cochrane Library ◽  
State Examination

ABSTRACTObjective:To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).Method:A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).Result:More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p &lt; 0.001].Conclusion:The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.

Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study

2013 ◽  
Vol 25 (11) ◽  
pp. 1831-1838 ◽  
Author(s):  
YanHong Dong ◽  
Wah Yean Lee ◽  
Saima Hilal ◽  
Monica Saini ◽  
Tien Yin Wong ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Discriminant Validity ◽  
Mini Mental State Examination ◽  
Population Based ◽  
Montreal Cognitive Assessment ◽  
Population Based Study ◽  
State Examination

ABSTRACTBackground:We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study.Methods:This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI.Results:A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91–0.97) vs. 0.91 (95% CI = 0.86–0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80).Conclusion:Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.

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