MMSE and MoCA in Parkinson’s disease and dementia with Lewy bodies: a multicenter 1-year follow-up study

Abstract

The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to test cognitive impairment in Lewy body disease (LBD), but there is no consensus on which is best suited to assess cognition in clinical practice and most sensitive to cognitive decline. Retrospective cohort study of 265 LBD patients [Parkinson’s disease (PD) without dementia (PDnD, N = 197), PD with dementia (PDD, N = 40), and dementia with Lewy bodies (DLB, N = 28)] from an international consortium who completed both the MMSE and MoCA at baseline and 1-year follow-up (N = 153). Percentage of relative standard deviation (RSD%) at baseline was the measure of inter-individual variance, and estimation of change (Cohen’s d) over time was calculated. RSD% for the MoCA (21 %) was greater than for the MMSE (13 %) (p = 0.03) in the whole group. This difference was significant only in PDnD (11 vs. 5 %, p < 0.01), but not in PDD (30 vs. 19 %, p = 0.37) or DLB (15 vs. 14 %, p = 0.78). In contrast, the 1-year estimation of change did not differ between the two tests in any of the groups (Cohen’s effect <0.20 in each group). MMSE and MoCA are equal in measuring the rate of cognitive changes over time in LBD. However, in PDnD, the MoCA is a better measure of cognitive status as it lacks both ceiling and floor effects.

Cognitive Estimation in Non-demented Parkinson's Disease

“…However, future work might explore this further in a larger PD sample. We also acknowledge that the MMSE is considered a less sensitive measure of cognitive status in PD compared to the Montreal Cognitive Assessment Battery (MOCA; Nasreddine et al, 2005), as the MOCA also assesses executive, visuospatial and memory abilities (Aarsland, 2016;Biundo et al, 2016). A limitation of our study may be the inclusion of some PD individuals in the earliest stages of dementia, who were not detected using the MMSE.…”

The prognosis of dementia with Lewy bodies

“…16,17 . However, the sensitivity to change in DLB has been reported to be similar in MoCA and MMSE 18 . However, subdomain-specific cognitive decline has rarely been assessed in DLB.…”

Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) performance in progressive supranuclear palsy and multiple system atrophy

“…On the contrary, the Montreal Cognitive Assessment (MoCA) is a brief cognitive screening tool (Nasreddine et al 2005), which has shown high sensitivity and specificity for the assessment of cognitive deficits in PD (Gill et al 2008;Hoops et al 2009;Zadikoff et al 2008). Several studies already reported the superiority of MoCA over MMSE in general population (Luis et al 2009), in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and Huntington's disease (HD) (Biundo et al 2016;Hoops et al 2009;Nasreddine et al 2005;Videnovic et al 2010). However, experience in PSP and MSA is limited.…”