The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment

Université de Sherbrooke, Шербрук, Quebec, Canada
Journal of the American Geriatrics Society (Impact Factor: 4.57). 05/2005; 53(4):695-9. DOI: 10.1111/j.1532-5415.2005.53221.x
Source: PubMed


To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia.
Validation study.
A community clinic and an academic center.
Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC).
The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD.
Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively).
MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.

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Available from: Natalie A. Phillips, Oct 13, 2015
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    • "hese results suggest that it was likely the change in performance of low - scoring indi - viduals that led to the significant increase in scores between the first and second administrations , the test – retest interval where practice effects are typically observed . Although 26 is the recommended cutoff to detect cognitive impairment on the MoCA ( Nasreddine et al . , 2005 ) , subsequent studies have revealed questionable speci - ficity of this criterion . For example , Luis et al . ( 2009 ) demonstrated that the MoCA cut - off score of 26 only had 35% specificity in identifying individuals with cognitive impairment . Alternatively , utilizing a cutoff score of 23 exhibited 95% specificity , while retaini"
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    ABSTRACT: Objective: The Montreal Cognitive Assessment (MoCA) is a brief screening measure commonly used to determine cognitive status among older adults. Despite the popularity of the MoCA, there has been little research into how performance on the MoCA changes over time in healthy older adults. Methods: The present study examined a sample of older adults (n = 53) recruited for a longitudinal study of healthy aging. Change in total MoCA score at three time points (baseline, 12 months, and 48 months) and scores from the Repeatable Battery for the Assessment of Neuropsychological Status at five time points (RBANS; baseline 12 months, 24 months, 36 months, and 48 months) were assessed using repeated measures analyses. Results: Total MoCA score significantly increased across time, particularly between the first and second administrations. Scores did not significantly differ between the second (12 month) and third (48 month) administrations. When grouped by baseline performance, individuals who scored low at baseline significantly improved performance at 12-month testing, but had little change between 12- and 48-month testing. Conversely, individuals who scored high at baseline did not significantly change between baseline and 12-month testing, but improved between 12- and 48-month testing. RBANS scores did not significantly change over time. Conclusions: These results suggest that the MoCA may be susceptible to practice effects, particularly between the first and second administrations. These practice effects should be taken into consideration when repeatedly employing the MoCA to screen for cognitive status in healthy older adults.
    The Clinical Neuropsychologist 09/2015; DOI:10.1080/13854046.2015.1087596 · 1.72 Impact Factor
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    • "was administered to all constructors . Participants were presented with 40 pairs of faces , and asked to make same / different judgments . Scores were calculated out of 40 , with one point awarded for each correct detection or discrimination . Older adult participants were additionally screened using the Montreal Cognitive Assessment Tool ( MoCA ; Nasreddine et al . , 2005 ) . This cognitive - screening tool takes little time to administer and assesses potential mild cognitive impairment . Cognitively - intact older adults typically score in the range of 26 or above . Therefore , adults scoring 26 or less on this assessment did not participate to completion in the study . This was to ensure that any effec"
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    Frontiers in Psychology 09/2015; 6:1237. DOI:10.3389/fpsyg.2015.01237 · 2.80 Impact Factor
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    • "ultiple domains of cognitive function , including executive functions , attention , language , memory , and orientation in a short 30 - point test . It has good internal consistency and test - retest reliability , and correctly identified 90% of a large sample of individuals with MCI from two different clinics with a cut - off score of < 26 / 30 ( Nasreddine et al . , 2005 ) . The time of day during which the MMSE and MoCA were administered varied across participants ( ranging from 09 : 00 to 17 : 00 h ) ."
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    ABSTRACT: Sleep quality decreases with aging and thus sleep complaints are prevalent in older adults, particularly for those with cognitive impairment and dementia. For older adults, emerging evidence suggests poor sleep quality increases risk of developing cognitive impairment and dementia. Given the aging population—and the impending economic burden associated with increasing numbers of dementia patients—there is pressing need to improve sleep quality among older adults. As such, research efforts have increased focus on investigating the association between age-related sleep changes and cognitive decline in older adults. Sleep quality is a complex construct to evaluate empirically, and yet the Pittsburg Sleep Quality Index (PSQI) is commonly used in studies as their only measure of sleep quality. Furthermore, the PSQI may not be the best sleep quality measure for older adults, due to its reliance on the cognitive capacity to reflect on the past month. Further study is needed to determine the PSQI's validity among older adults. Thus, the current study examined sleep quality for 78 community dwelling adults 55+ to determine the PSQI's predictive validity for objective sleep quality (as measured by actigraphy). We compared two subjective measures of sleep quality—the PSQI and Consensus Sleep Diary (CSD)—with actigraphy (MotionWatch 8©; camntech). Our results suggest perceived sleep quality is quite different from objective reality, at least for adults 55+. Importantly, we show this difference is unrelated to age, gender, education, or cognitive status (assessed using standard screens). Previous studies have shown the PSQI to be a valuable tool for assessing subjective sleep quality; however, our findings indicate for older adults the PSQI should not be used as a substitute for actigraphy, or vice versa. Hence, we conclude best practice is to include both subjective and objective measures when examining sleep quality in older adults (i.e., the PSQI, CSD, and actigraphy).
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