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Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly?

Published online by Cambridge University Press:  14 November 2018

Tiago C. C. Pinto Open the ORCID record for Tiago C. C. Pinto [Opens in a new window] ,
Leonardo Machado ,
Tatiana M. Bulgacov ,
Antônio L. Rodrigues-Júnior ,
Maria L. G. Costa ,
Rosana C. C. Ximenes  and
Everton B. Sougey
Tiago C. C. Pinto*
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Leonardo Machado
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Tatiana M. Bulgacov
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Antônio L. Rodrigues-Júnior
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Maria L. G. Costa
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Rosana C. C. Ximenes
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Everton B. Sougey
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
*
Correspondence should be addressed to: Tiago Coimbra Costa Pinto, Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Avenida da Engenharia, S/N, Prédio dos Programas de Pós-Graduação do CCS-UFPE, Cidade Universitária, Recife-PE 50740-600, Brazil. Phone: +55 87 988727241; Fax: +55 81 21268539. Email: tcoimbra.pinto@gmail.com.
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Abstract

Objective:

To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).

Method:

A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).

Result:

More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p < 0.001].

Conclusion:

The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.

Keywords

Cognitive assessmentAlzheimer’s diseasemild cognitive impairmentdiagnosis and classificationearly onset dementia
Type
Review Article
Information
International Psychogeriatrics , Volume 31 , Issue 4: Issue Theme: Aging and Well-Being , April 2019 , pp. 491 - 504
Copyright
© International Psychogeriatric Association 2018 

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