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Improving precision in the quantification of cognition using the Montreal Cognitive Assessment and the Mini-Mental State Examination

Published online by Cambridge University Press:  01 February 2011

Lisa Koski ,
Haiqun Xie  and
Susanna Konsztowicz
Lisa Koski*
Affiliation:
Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada Divisions of Geriatrics and of Clinical Epidemiology, Department of Medicine, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
Haiqun Xie
Affiliation:
Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
Susanna Konsztowicz
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
*
Correspondence should be addressed to: Dr. Lisa Koski, Royal Victoria Hospital, R4.74, 687 Pine Avenue West, Montreal, QC H3A 1A1, Canada. Phone: +1 514-934-1934, ext. 34420; Fax: +1 514-843-1734. Email: lisa.koski@mcgill.ca.
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Abstract

Background: The Montreal Cognitive Assessment (MoCA) can be used to quantify cognitive ability in older persons undergoing screening for cognitive impairment. Although highly sensitive in detecting mild cognitive impairment, its measurement precision is weakest among persons with milder forms of impairment. We sought to overcome this limitation by integrating information from the Mini-Mental State Examination (MMSE) into the calculation of cognitive ability.

Methods: Data from 185 geriatric outpatients screened for cognitive impairment with the MoCA and the MMSE were Rasch analyzed to evaluate the extent to which the MMSE items improved measurement precision in the upper ability ranges of the population.

Results: Adding information from the MMSE resulted in a 13.8% (13.3–14.3%) reduction in measurement error, with significant improvements in all quartiles of patient ability. The addition of three-word repetition and recall, copy pentagons, repeat sentence, and write sentence improved measurement of cognition in the upper levels of ability.

Conclusions: The algorithm presented here maximizes the yield of available clinical data while improving measurement of cognitive ability, which is particularly important for tracking changes over time in patients with milder levels of impairment.

Keywords

geriatriccognitive impairmentdementiameasurementRaschMoCAMMSE
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 7 , September 2011 , pp. 1107 - 1115
Copyright
Copyright © International Psychogeriatric Association 2011

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