MoCA (Montreal Cognitive Assessment)

Purpose:
Detection of mild cognitive impairment.

Rationale:
Previous screening tolls, like the MMSE, do not adequately detect mild cognitive impairment.

The Test:
The test is availabe online in several languages here: http://www.mocatest.org/.

Validation:
In the original study (Nasreddine 2005) using a cutoff score of 26 the sensitivity was 90% for MCI and 100% for AD. Specificity was 87% in both groups.

In another study (Smith 2007), in a memory clinic setting, sensitivity was 83% for MCI and 94% for AD. However, specificity was only 50%.

A validation of a Korean version (Lee 2008), using a cutoff score of 22/23, had a sensitivity of 89% and a specificity of 84% for screening MCI. Internal consistency and test−retest reliability were good.

Another validation study (Luis 2009) examined a community-based cohort residing in the Southeastern United States for MCI. Using the cut-off score of 26, the sensitivity was 97%, but specificity was only 35%. Using a lower cut-off score of 23, sensitivity was 96% and specificity was 95%.

A validation in an oupatient cardiac and diabetic/endocrine clinics patient population was performed. (McLennan 2011) The presence of MCI was determined using the Neuropsychological Assessment Battery Screening Module (NAB-SM). Using a cutoff of 24, sensitivity for amnestic MCI was 100% and for multiple-domain MCI it was 83.3%. Specificity rates for amnestic MCI and multiple-domain MCI were 50.0% and 52% respectively.

References:
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., … Chertkow, H. (January 01, 2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 4, 695-9.

Smith, T., Gildeh, N., & Holmes, C. (January 01, 2007). BRIEF COMMUNICATION – The Montreal Cognitive Assessment: Validity and Utility in a Memory Clinic Setting. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 52, 5, 329.

Lee, J.-Y., Dong, W. L., Cho, S.-J., Na, D., Hong, J. J., Kim, S.-K., You, R. L., … Maeng, J. C. (January 01, 2008). Brief Screening for Mild Cognitive Impairment in Elderly Outpatient Clinic: Validation of the Korean Version of the Montreal Cognitive Assessment. Journal of Geriatric Psychiatry and Neurology, 21, 2, 104-110.

Koski, L., Xie, H., & Finch, L. (January 01, 2009). Measuring Cognition in a Geriatric Outpatient Clinic: Rasch Analysis of the Montreal Cognitive Assessment. Journal of Geriatric Psychiatry and Neurology, 22, 3, 151-160.

Luis, C. A., Keegan, A. P., & Mullan, M. (July 01, 2009). Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US. International Journal of Geriatric Psychiatry, 24, 2, 197-201.

McLennan, S. N., Mathias, J. L., Brennan, L. C., & Stewart, S. (January 01, 2011). Validity of the Montreal Cognitive Assessment (MoCA) as a Screening Test for Mild Cognitive Impairment (MCI) in a Cardiovascular Population. Journal of Geriatric Psychiatry and Neurology, 24, 1, 33-38.

Bernstein, I., Lacritz, L., Barlow, C., Weiner, M., & DeFina, L. (January 01, 2011). Psychometric Evaluation of the Montreal Cognitive Assessment (MoCA) in Three Diverse Samples. The Clinical Neuropsychologist, 25, 1, 119-126.

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