The Influence of Education on Chinese Version of Montreal Cognitive Assessment in Detecting Amnesic Mild Cognitive Impairment among Older People in a Beijing Rural Community

Zhou, Shu’aijun; Zhu, Jianzhong; Zhang, Na; Wang, Bailing; Li, Tao; Lv, Xiaozhen; Ng, Tze Pin; Yu, Xin; Wang, Huali

doi:10.1155/2014/689456

Cited by 43 publications

(42 citation statements)

References 17 publications

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“…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.…”

Section: Discussionsupporting

confidence: 92%

“…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. Zhou et al [22] evaluated the MoCA among rural-living elderly subjects in two villages in the outskirts of Beijing and reported an AUC of 0.72 (at a cut-off of 20/21) with Sn = 0.75 and Sp = 0.62. Both studies showed that the MoCA performed no better than the MMSE.…”

Section: Discussionmentioning

confidence: 99%

“…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]. …”

Section: Introductionmentioning

confidence: 99%

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

Feng

Lim

et al. 2015

Dement Geriatr Cogn Disord

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Background: The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. Method: The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η² = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η² = 0.115 and η² = 0.162, respectively). Conclusion: The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Feng

Lim

et al. 2015

Dement Geriatr Cogn Disord

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“…In addition, certain items on the MoCA are likely to be influenced by education [43], for instance, clock drawing, phonemic verbal fluency, and verbal abstraction [59].…”

Section: Discussionmentioning

confidence: 99%

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

O’Driscoll

Shaikh

2017

JAD

152

121

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The MoCA is widely used to screen for mild cognitive impairment. While there are many available versions, the cross cultural validity of the assessment has not been explored sufficiently.We aimed to interrogate the validity of the MoCA in a cross-cultural context: in differentiating mild cognitive impairment (MCI) from normal controls (NC); and identifying cut-offs and adjustments for age and education where possible. This review sourced a wide range of studies including case-control studies. In addition, we report findings for differentiating dementias from NC and MCI from dementias, however, these were not considered to be an appropriate use of the MoCA.The subject of the review assumes heterogeneity and therefore meta-analysis/es was not conducted. Quality ratings, forest plots of validated studies (sensitivity and specificity) with covariates (suggested cut-offs, age, education and country) and summary received operating characteristic curve (sROC) are presented.The results showed a wide range in suggested cutoffs for MCI cross culturally, with variability in levels of sensitivity and specificity ranging from low to high. Poor methodological rigour appears to have affected reported accuracy and validity of the MoCA.The review highlights the necessity for cross cultural considerations when using the MoCA, and recognizing it as a screen and not a diagnostic tool. Appropriate cutoffs and point adjustments for education are suggested.2

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“…In the Singapore population, the cutoff scores of 26/27 and 24/25 are used to detect aMCI and mild AD, respectively [8]. Moreover, a study on the Chinese version of the MoCA (C-MoCA) has shown that among the rural elderly people, the MoCA showed modest accuracy and was no better than the MMSE in detecting aMCI, especially in those with low education levels, due to the overwhelming effect of education relative to aMCI diagnosis on variations in C-MoCA performance [9]. Consistent with the above results, the C-MoCA was applied in our study and was successful in accurately screening the PD-MCI and PD-D patients.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Creatine and Coenzyme Q10 Combination Therapy on Mild Cognitive Impairment in Parkinson's Disease

Li¹,

Wang²,

Zhou³

et al. 2015

Eur Neurol

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Background: To investigate the effect of creatine and coenzyme Q10 (CoQ10) combination therapy on mild cognitive impairment (MCI) in Parkinson's disease (PD; PD-MCI) and its influences on plasma phospholipid (PL) levels in PD-MCI. Methods: The demographic data of 75 PD-MCI patients who enrolled in this collaborative PD study were collected. These patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) III and the Montreal Cognitive Assessment (MoCA). These 75 PD-MCI patients were randomly treated with creatine monohydrate 5 g b.i.d. and CoQ10 100 mg t.i.d. orally or placebo. MoCA evaluation and PL level measurements were performed after 12 and 18 months of treatment. Results: After 12 and 18 months of treatment, the differences in the MoCA scores of the combination therapy and control groups were statistically significant (p < 0.05 at 12 months and p < 0.01 at 18 months), and the plasma PL levels of the combination therapy group were significantly lower than those of the control group (p < 0.01 at 12 months and p < 0.001 at 18 months). Conclusions: Combination therapy with creatine and CoQ10 could delay the decline of cognitive function in PD-MCI patients and could lower their plasma PL levels; therefore, this combination therapy may have a neuroprotective function.

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The Influence of Education on Chinese Version of Montreal Cognitive Assessment in Detecting Amnesic Mild Cognitive Impairment among Older People in a Beijing Rural Community

Cited by 43 publications

References 17 publications

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

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

Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review

The Effect of Creatine and Coenzyme Q10 Combination Therapy on Mild Cognitive Impairment in Parkinson's Disease

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