Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91

Abstract

(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18–91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.

Long-term cognitive performance and its relation to anti-inflammatory therapy in a cohort of survivors of severe COVID-19

“…Overall, 26 participants (27%) were classified as cognitively impaired based on their test results. More specifically, the (age-, sex- and education corrected ( Kessels et al, 2022 )) MoCA was impaired (T-score < -1.5 SD) in 5% of patients. On executive functioning tests, 21% of patients scored impaired on TMT-B/A, and 18% on the Digit Span test.…”

“…We compared individual neuropsychological test results to available Dutch normative data, resulting in standardized, age-, sex-, and education-adjusted T-scores (M = 50, SD = 10). Also, we converted the MoCA results to T-scores corrected for age and education, based on data from healthy Dutch controls ( de Vent et al, 2016 ; Kessels et al, 2022 ). Consequently, an overall T-score was calculated by averaging the T-scores of all cognitive tests.…”

Cognitive assessment during inpatient rehabilitation after spinal cord injury, a retrospective cross-sectional study

“…Recent studies have been questioning the cut-off values of the MoCA in the healthy population as well. [22,25,26]. Kessels et all presented new normative data taking age, educational level and gender into account [22].…”

Coordination and Cognition in Pure Nutritional Wernicke’s Encephalopathy with Cerebellar Degeneration after COVID-19 Infection: A Unique Case Report

“…Our findings also show that caution is required when administering and interpreting cognitive screens, such as the MoCA or CCAS scale, in individuals with lower intellectual abilities or lower education levels, as such screening instruments have a suboptimal specificity that is attenuated in individuals with lower premorbid cognitive function. For instance, there is abundant evidence that a substantial proportion of cognitively healthy participants are misclassified as having cognitive impairment when using the established cut-off score of the MoCA, as this cut-off score insufficiently adjusts for (lower) educational attainment [ 91 ]. Similarly, a recent study using the CCAS scale for detecting cognitive deficits in spinocerebellar ataxia type 3 also demonstrated that some of the healthy controls performed in the impaired range on this scale [ 92 ].…”