However, another study raised the issue that the single cutoff score of HK-MoCA was associated with a substantially high misclassification rate especially in older and less-educated patients with stroke. 4, 5 A score of less than 22 is considered positive for screening and calls for further diagnostic assessment. In Hong Kong, a local version of MoCA, the Hong Kong version (HK-MoCA), was validated in Chinese older adults. 3 Demographically adjusted norms may help improve the diagnostic accuracy. Moreover, the one-point correction for education has been debated as insufficient to compensate for educational differences. 2 Some studies have revealed that the originally recommended cutoff score of 26 leads to a higher false positive misclassification especially on those with increasing age and/or low education. Systematic review highlighted the necessity for cross-cultural considerations when using the MoCA as a screening tool. 1 There is a one-point adjustment for individuals with formal education of 12 years or fewer. The Montreal Cognitive Assessment (MoCA) is a brief, useful and validated cognitive screening instrument with a cutoff score of 26 to differentiate mild cognitive impairment (MCI) or dementia from normal. A cognitive screening measure with high sensitivity and specificity is essential for them to decide who needs a more detailed evaluation or make a referral for comprehensive geriatric assessments, including neuropsychological evaluations. Individuals concerned about their memory loss are mostly seen by primary care physicians. Poor memory is one of the commonest presenting complaints and other features include disturbances of behaviour, language, mood, personality or perception. Mild Cognitive Impairment MoCA Montreal Cognitive Assessment cutoff scores diagnostic accuracy.Dementia is a major neurodegenerative disorder and often begins with focal cognitive or behavioural disturbances. We recommend the use of this cutoff score going forward. Meta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters.Ī MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. 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. Of the 304 studies identified, nine met inclusion criteria for the meta-analysis. 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.
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. Several validation studies have been conducted on the MoCA, in a variety of clinical populations. 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).
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