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- Title
Montreal Cognitive Assessment for Screening Mild Cognitive Impairment: Variations in Test Performance and Scores by Education in Singapore.
- Authors
Ng, Tze Pin; Feng, Lei; Lim, Wee Shiong; Chong, Mei Sian; Lee, Tih Shih; Yap, Keng Bee; Tsoi, Tung; Liew, Tau Ming; Gao, Qi; Collinson, Simon; Kandiah, Nagaendran; Yap, Philip
- Abstract
Background: The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. Method: The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η2 = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η2 = 0.115 and η2 = 0.162, respectively). Conclusion: The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis. © 2015 S. Karger AG, Basel
- Subjects
SINGAPORE; COGNITION disorders diagnosis; CHI-squared test; MAGNETIC resonance imaging; RESEARCH methodology; MULTIVARIATE analysis; PROBABILITY theory; PSYCHOLOGICAL tests; QUESTIONNAIRES; RESEARCH funding; ACTIVITIES of daily living; RECEIVER operating characteristic curves; RESEARCH methodology evaluation; GERIATRIC Depression Scale; DATA analysis software
- Publication
Dementia & Geriatric Cognitive Disorders, 2015, Vol 39, Issue 3/4, p176
- ISSN
1420-8008
- Publication type
Article
- DOI
10.1159/000368827