Background and Purpose A new approach was proposed to score the Montreal Cognitive Assessment (MoCA) index scores for 6 cognitive domains: orientation (OIS), attention (AIS), language (LIS), visuospatial function (VIS), memory (MIS), and executive function (EIS). This study investigated whether the MoCA index scores represent the functions of each cognitive domain by examining the correlations with the corresponding cognitive domain scores derived from conventional neuropsychological tests included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II). Methods The participants were 104 amnestic mild cognitive impairment (aMCI), 74 vascular mild cognitive impairment (VaMCI), 73 dementia of the Alzheimer's type (DAT), and 41 vascular dementia (VaD) patients. All participants were administered the Korean-MoCA and SNSB-II. Results Like the MoCA total score, the MoCA-OIS, MoCA-VIS, and MoCA-MIS showed differences between aMCI and AD groups and between VaMCI and VaD groups. The MoCA-AIS, MoCA-LIS, and MoCA-EIS showed significant differences between VaMCI and VaD groups, but no difference between aMCI and DAT groups. In the aMCI and VaMCI groups, all index scores of the MoCA showed significant correlations with the corresponding cognitive domain scores of the SNSB-II. Except for MoCA-MIS, the MoCA-AIS, MoCA-LIS, MoCA-VIS, and MoCA-EIS also showed significant correlations with the corresponding domain scores of the SNSB-II in the DAT and VaD groups. Conclusions These results indicate that all MoCA index scores, except for MoCA-MIS, which does not reflect the severity of memory impairment in dementia patients, provide highly valid information on the function of each cognitive domain in patients with mild cognitive impairment and dementia.

The present study was conducted to examine when verbal fluency is decreased in amnestic multi-domain mild cognitive impairment (MCI) and vascular MCI, and to compare the deterioration characteristics in verbal fluency between amnestic multi-domain MCI and vascular MCI. Methods: The subjects were 34 normal elderly, 36 with dementia of the Alzheimer type, 39 with vascular dementia, 72 with amnestic multi-domain MCI, and 70 with vascular MCI. The MCI groups were classified into two subgroups, early MCI (0.5-2.0) and late MCI (2.5-4.0), based on the Clinical Dementia Rating-Sum of Boxes. The subjects were given semantic (animal) and phonemic (ㄱ, ㅇ, ㅅ) fluency tests. Results: In amnestic multi-domain MCI, semantic fluency showed progressive deterioration from the early amnestic multi-domain MCI to early dementia of the Alzheimer's type, whereas in vascular MCI it was significantly decreased in the late vascular MCI but maintained in early vascular dementia. In vascular MCI, phonemic fluency had progressive deterioration from the early vascular MCI to early vascular dementia, whereas in amnestic multi-domain MCI it was significantly decreased in the early amnestic multi-domain MCI and maintained in early dementia of the Alzheimer's type. Conclusion: These results suggest that the deterioration characteristics of semantic and phonemic fluency are different between amnestic multi-domain MCI and vascular MCI.

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Background and Purpose The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer’s type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.