Determining an appropriate cutting score for indication of impairment on the Montreal Cognitive Assessment

Waldron-Perrine, Brigid; Axelrod, Bradley N.

doi:10.1002/gps.3768

Cited by 110 publications

(81 citation statements)

References 18 publications

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“…Nevertheless, our results already suggest that all MoCA versions show a comparable discriminate power for MCI and AD, which is in line with previous studies [12,36,37]. However, the appropriate cutoff value seems to be population-specific [38], and therefore the discriminative validity and other psychometric measures, such as test-retest reliability, as well as the utility of populationbased norms, should be further addressed in future studies using the MoCA alternate forms, particularly when studying other populations. Due to its indisputable clinical usefulness, the sensitivity of the MoCA and its alternate forms to detect changes across time should be one of the next steps in the further validation of this cognitive measure.…”

Section: Discussionsupporting

confidence: 75%

Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Costa¹,

Fimm²,

Friesen

et al. 2012

Dement Geriatr Cogn Disord

109

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Aims: The Montreal Cognitive Assessment (MoCA) has gained recognition for its validity in detecting cognitive impairment in several clinical populations. For serial assessments, alternate forms are needed to overcome possible practice effects. Our objective was to investigate the reliability of two German MoCA alternate forms for longitudinal assessment applications. Methods: The original and one of two alternate forms of the MoCA were administered within a 60-min interval of a clinical interview in a counterbalanced order to 100 healthy elderly controls, 30 patients with mild cognitive impairment (MCI) and 30 patients with Alzheimer’s disease (AD). The diagnosis of the majority of patients was supported by in vivo AD pathology biomarkers. Results: There was a strong correlation between the alternate forms and the original MoCA in all groups, but particularly in the clinical samples. Total mean scores did not differ significantly between the MoCA versions, even taking into account the presentation order. As in previous studies, age and education influenced performance in the MoCA. The same pattern of group differences (controls > MCI > AD) was observed for each of the versions. Conclusion: All three forms can be reliably and interchangeably used in serial cognitive assessment, confirming the MoCA’s applicability in research and clinical longitudinal approaches.

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Section: Discussionsupporting

confidence: 75%

Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Costa¹,

Fimm²,

Friesen

et al. 2012

Dement Geriatr Cogn Disord

109

View full text Add to dashboard Cite

show abstract

“…However, we used a well-tested survey adaptation of a screening tool, the MoCA-SA, 28,39 as well as appropriate cutoffs for a community sample. [42][43][44] A sensitivity analysis utilizing both a continuous cognitive measure and multiple different cutoffs yielded similar associations with social variables (data available on request). Second, the study was cross-sectional, reducing our ability to make causal claims, particularly about whether social or cognitive changes occurred first.…”

Section: Discussionmentioning

confidence: 99%

“…Questions remain regarding most appropriate cutoffs from the MoCA to screen for MCI or dementia; studies from selected clinical samples favor higher cutoff values to define MCI, 38,40,41 compared to community-based studies, [42][43][44] which accept lower cutoffs. We divided the scale into three categories based on community samples: >22 points (normal), 18-22 points (screen positive for MCI), < 18 points (screen positive for dementia).…”

Section: Methodsmentioning

confidence: 99%

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

et al. 2016

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BACKGROUND: An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE: We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender. DESIGN: United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP). PARTICIPANTS: Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %. MAIN MEASURES: Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition. KEY RESULTS: Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively. CONCLUSION: Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers.

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“…a more conservative cut-off of <24, and 2.) MoCA scores as a continuous variable, as it has been suggested that the original cut-off may yield low levels of specificity for cognitive impairment (19,20).…”

Section: Cognitive Functionmentioning

confidence: 99%

Cognitive Impairment, Vulnerability, and Mortality Post Ischemic Stroke: A Five-Year Follow-Up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Cohort

Gaynor

Rohde

Large

et al. 2018

Journal of Stroke and Cerebrovascular Diseases

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Determining an appropriate cutting score for indication of impairment on the Montreal Cognitive Assessment

Abstract: Use of the previously suggested cut score of <26 may overpathologize neurologically intact individuals. Further research utilizing ROC curve analysis should be conducted to establish appropriate cutoff scores for various populations which may differ from the present sample.

Cited by 110 publications

References 18 publications

Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Alternate-Form Reliability of the Montreal Cognitive Assessment Screening Test in a Clinical Setting

Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults

Cognitive Impairment, Vulnerability, and Mortality Post Ischemic Stroke: A Five-Year Follow-Up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Cohort

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