MOCA SCORE FREE
The MoCA is free to clinicians ( ) and has been translated into 31 different languages and dialects. They found that 66% of their sample fell below the cut score of 26, indicating “impairment,” and that many of the MoCA items had high failure rates. Rossetti and colleagues (2011) attempted to correct these problems by conducting a normative study of the MoCA in an ethnically diverse sample of healthy participants, as presented in Table 44.5. Additionally, the original cut score of 26 used to identify impairment was developed without fully accounting for other variables that affect test performance (e.g., age, education, sex, and race) and the score has also been shown to identify a high number of false positives in certain populations. First, some studies have demonstrated that its reliability is notably low in nonclinical populations ( Bernstein et al., 2011), which indicates that it should primarily be used only to detect suspected cognitive impairment in clinical patients. Since its inception as a screening measure for MCI, other studies have found the MoCA to outperform the MMSE in screening for general cognitive impairment in Parkinson disease (PD) ( Hoops et al., 2009 Nazem et al., 2009), vascular dementia after acute stroke ( Dong et al., 2010), and Huntington disease (HD) ( Videnovic et al., 2010) as a measure sensitive to early stages of different types of dementia.Īlthough the MoCA has demonstrated its utility as a cognitive screener, there are a few caveats worth noting. More important, the positive predictive value of the MoCA is 89% for both MCI and AD. The total score ranges from 0 to 30 points, and a cut score of 26 has demonstrated very good specificity (by correctly identifying 87% of healthy participants) and excellent sensitivity when differentiating MCI (90%) and Alzheimer disease (AD) (100%) from healthy comparisons. Including more cognitive domains reduces the likelihood that impairments or disorders will be overlooked (e.g., executive dysfunction, a hallmark symptom of vascular dementia). The MoCA also improved upon the MMSE by probing more cognitive domains, including executive functioning, immediate and delayed memory, visuospatial abilities, attention, working memory, language, and orientation to time and place ( Fig. The MoCA was originally developed as a screening tool to correct the shortcomings of the widely used MMSE, which demonstrated an insensitivity to mild cognitive impairment ( Nasreddine et al., 2005). Individuals with MCI with a low MoCA-TS and a low newly devised memory index score (MoCA-MIS) are at greater risk of short-term conversion to AD.Joseph Jankovic MD, in Bradley and Daroff's Neurology in Clinical Practice, 2022 Montreal Cognitive Assessment Individuals with multiple-domain amnestic MCI had the highest AD conversion rates (73.9%).ĬONCLUSION: Identifying individuals with MCI at high risk of conversion to AD is important clinically and for selecting appropriate subjects for therapeutic trials. RESULTS: One hundred fourteen participants progressed to AD (MCI-AD), and 51 did not (nonconverters MCI-NC) 90.5% of participants with MCI with a MoCA-TS less than 20/30 and a MoCA-MIS less than 7/15 at baseline converted to AD within the average follow-up period of 18 months, compared with 52.7% of participants with MCI above the cutoffs on both scores. MEASUREMENTS: Baseline MoCA scores at MCI diagnosis were collected from charts of eligible individuals with MCI, and MoCA-TS, MoCA-MIS, and a cognitive domain index score were calculated to assess their prognostic value in predicting conversion to AD. PARTICIPANTS: Individuals meeting Petersen's MCI criteria (N = 165).
OBJECTIVES: To assess the usefulness of the Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) in predicting conversion to Alzheimer's disease (AD) in individuals with mild cognitive impairment (MCI).
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