This meta-analysis and systematic review explored the pooled global prevalence of MCI among older adults living in nursing homes and its relevant factors. Mild cognitive impairment (MCI) is the early stage of cognitive impairment between the expected cognitive decline of normal aging and the more serious decline of dementia. MoCA, MMSE and MiniCog showed similar discriminative ability for cognitive impairment, with MoCa and MMSE showing greater sensitivity and MiniCog the highest specificity. Cognitive impairment was detected in more than one-third of hypertensive older adults without prior diagnosis of dementia. The sensitivity of MoCA (80%) and of MMSE/MiniCog combination (74%) was higher in comparison with MiniCog alone (49%, p = 0.007 and 0.004, respectively), while MiniCog achieved the highest specificity (88%, p < 0.001 vs all). The MoCA (AUC = 0.746), the MMSE (AUC = 0.689) and the MiniCog (AUC = 0.684) showed similar ability in detecting cognitive impairment, while the CDT had a poorer discriminative capacity (AUC = 0.535). Cognitive impairment was diagnosed in 37% of 94 participants (mean age 76, 55% female), mainly involving attention and executive functions.
The ROC curve analysis and the paired chi-square test were used to compare the discriminative ability, sensitivity and specificity for cognitive impairment of the different screening instruments.
Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), MiniCog and Clock Drawing Test (CDT) were administered, using a comprehensive neuropsychological assessment as gold standard. The study involved hypertensive patients aged 65+ without prior diagnosis of cognitive impairment, from the Hypertension Clinic of Careggi Hospital, Florence, Italy. This study investigated cognitive impairment in hypertensive older adults and compared the discriminative ability of the most widely used cognitive screening tests. Yet, the most suitable cognitive screening test for hypertensive patients has yet to be identified. Hypertension is a major risk factor for dementia. MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE. For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Papers which met inclusion and exclusion criteria were chosen to be included in this review. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points.Ī systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. North American Neuro-Ophthalmology Association.Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment.
MoCA© may be used, reproduced, and distributed WITHOUT permission. Nasreddine 2003 to 2015 - The Montreal Cognitive Assessment - MoCA© - All rights reserved. Nasreddine, Montreal Cognitive Assessment - MoCA©Ĭopyright© Dr Z. The MoCA© is a cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment. Ziad Nasreddine MD, MoCA Clinic & Institute Cognitive Disorders Cognitive Assessment MOCA test
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