Nicole Carson1, Larry Leach2, Kelly J Murphy3. 1. Department of Psychology, York University, Toronto, Ontario, Canada. 2. Department of Psychology, Glendon College, Toronto, Ontario, Canada. 3. Department of Neuropsychology and Cognitive Health, Baycrest Health Sciences and Departments of Psychology, University of Toronto and York University, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: The Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) is a cognitive screening tool that aims to differentiate healthy cognitive aging from Mild Cognitive Impairment (MCI). Several validation studies have been conducted on the MoCA, in a variety of clinical populations. Some studies have indicated that the originally suggested cutoff score of 26/30 leads to an inflated rate of false positives, particularly for those of older age and/or lower education. We conducted a systematic review and meta-analysis of the literature to determine the diagnostic accuracy of the MoCA for differentiating healthy cognitive aging from possible MCI. METHODS: Of the 304 studies identified, nine met inclusion criteria for the meta-analysis. These studies were assessed across a range of cutoff scores to determine the respective sensitivities, specificities, positive and negative predictive accuracies, likelihood ratios for positive and negative results, classification accuracies, and Youden indices. RESULTS: Meta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters. CONCLUSIONS: A MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. We recommend the use of this cutoff score going forward.
OBJECTIVE: The Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) is a cognitive screening tool that aims to differentiate healthy cognitive aging from Mild Cognitive Impairment (MCI). Several validation studies have been conducted on the MoCA, in a variety of clinical populations. Some studies have indicated that the originally suggested cutoff score of 26/30 leads to an inflated rate of false positives, particularly for those of older age and/or lower education. We conducted a systematic review and meta-analysis of the literature to determine the diagnostic accuracy of the MoCA for differentiating healthy cognitive aging from possible MCI. METHODS: Of the 304 studies identified, nine met inclusion criteria for the meta-analysis. These studies were assessed across a range of cutoff scores to determine the respective sensitivities, specificities, positive and negative predictive accuracies, likelihood ratios for positive and negative results, classification accuracies, and Youden indices. RESULTS: Meta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters. CONCLUSIONS: A MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. We recommend the use of this cutoff score going forward.
Authors: Cyrus Ahalt; Irena Stijacic-Cenzer; Bruce L Miller; Howard J Rosen; Deborah E Barnes; Brie A Williams Journal: J Am Geriatr Soc Date: 2018-09-19 Impact factor: 5.562
Authors: Gali H Weissberger; Laura Mosqueda; Annie L Nguyen; Anya Samek; Patricia A Boyle; Caroline P Nguyen; S Duke Han Journal: Aging Ment Health Date: 2019-02-10 Impact factor: 3.658
Authors: Nadia M Chu; Zhan Shi; Christine E Haugen; Silas P Norman; Alden L Gross; Daniel C Brennan; Michelle C Carlson; Dorry L Segev; Mara A McAdams-DeMarco Journal: Am J Kidney Dis Date: 2020-02-03 Impact factor: 8.860