The Beijing version of the montreal cognitive assessment as a brief screening tool for mild cognitive impairment: a community-based study

Abstract

BackgroundA cross-sectional validation study was conducted in several urban and rural communities in Beijing, China, to evaluate the effectiveness of the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) as a screening tool to detect mild cognitive impairment (MCI) among Chinese older adults.MethodsThe MoCA-BJ and the Mini-Mental State Examination (MMSE) were administered to 1001 Chinese elderly community dwellers recruited from three different regions (i.e., newly developed, old down-town, and rural areas) in Beijing. Twenty-one of these participants were diagnosed by experienced psychiatrists as having dementia, 115 participants were diagnosed as MCI, and 865 participants were considered to be cognitively normal. To analyze the effectiveness of the MoCA-BJ, we examined its psychometric properties, conducted item analyses, evaluated the sensitivity and specificity of the scale, and compared the scale with the MMSE. Demographic and regional differences among our subjects were also taken into consideration.ResultsUnder the recommended cut-off score of 26, the MoCA-BJ demonstrated an excellent sensitivity of 90.4%, and a fair specificity (31.3%). The MoCA-BJ showed optimal sensitivity (68.7%) and specificity (63.9%) when the cut-off score was lowered to 22. Among all the seven cognitive sub-domains, delayed recall was shown to be the best index to differentiate MCI from the normal controls. Regional differences disappeared when the confounding demographic variables (i.e., age and education) were controlled. Item analysis showed that the internal consistency was relatively low in both naming and sentence repetition tasks, and the diagnostic accuracy was similar between the MoCA-BJ and the MMSE.ConclusionsIn general, the MoCA-BJ is an acceptable tool for MCI screening in both urban and rural regions of Beijing. However, presumably due to the linguistic and cultural differences between the original English version and the Chinese version of the scale, and the lower education level of Chinese older adults, the MoCA-BJ is not much better than the MMSE in detecting MCI, at least for this study sample. Further modifications to several test items of the MoCA-BJ are recommended in order to improve the applicability and effectiveness of the MoCA-BJ in MCI screening among the Chinese population.

Montreal Cognitive Assessment for Screening Mild Cognitive Impairment: Variations in Test Performance and Scores by Education in Singapore

“…Our findings are in accord with several emerging studies in Chinese populations that indicate relatively lower levels of accuracy, Sn, and Sp than those previously reported [19,20,22]. Yu et al [19], conducting a study in Beijing involving a large heterogeneous population-based sample, reported a modest accuracy (AUC = 0.71) with Sn = 0.69 and Sp = 0.64 at a reduced cut-off of 22.…”

“…Since its first publication in 2005, studies have reported that the MoCA showed good-to-excellent performance in discriminating MCI from normal cognition among old people, with reported areas under the curve (AUCs) ranging between 0.82 and 0.95, a Sn from 0.79 to 0.97, and a Sp from 0.60 to 0.87 [10,11,12,13,14,15,16,17,18]. However, a small number of studies apparently failed to show similarly high AUCs (0.71-0.79), Sn (0.65-0.69), and Sp (0.64-0.78) at least in some subpopulations [19,20,21,22], or the MoCA was shown to perform no better than the MMSE [19,22,23]. …”

Uric formaldehyde levels are negatively correlated with cognitive abilities in healthy older adults

“…Research assistants [35] score was included and used as the index for general cognitive abilities. The MoCA is more sensitive in detecting cognitive decline than the widelyused Mini-Mental State Examination [35][36][37][38] . All the research assistants and clinicians were intensively trained and high inter-rater reliability was obtained (>90%).…”

Sleep and Cognitive Abnormalities in Acute Minor Thalamic Infarction

“…The Chinese versions of the mini mental state examination (MMSE) [13] and the Montreal cognitive assessment (MoCA) [14] were used to evaluate global cognitive performance. The auditory verbal learning test (AVLT) was used to test auditory or verbal episodic memory.…”