![]() ![]() MoCA and MMSE were more similar for dementia cases, but MoCA distributes MCI cases across a broader score range with less ceiling effect. Mean FAQ scores were significantly higher and a greater proportion had abnormal FAQ scores in dementia than MCI and HC. The core and orientation domains in both tests best distinguished HC from MCI groups, whereas comprehension/executive function and attention/calculation were not helpful. ROC analysis found MoCA ≥ 17 as the cutoff between MCI and dementia that emphasized high sensitivity (92.3 %) to capture MCI cases. Equi-percentile equating showed a MoCA score of 18 was equivalent to MMSE of 24. MoCA and MMSE scores correlated most for dementia ( r = 0.86 versus MCI r = 0.60 HC r = 0.43). The ceiling effect (28–30 points) for MCI and HC was less using MoCA (18.1 %) versus MMSE (71.4 %). Most dementia cases scored abnormally, while MCI and HC score distributions overlapped on each test. Receiver Operating Characteristic (ROC) analyses evaluated lower cutoff scores for capturing the most MCI cases. Equi-percentile equating produced a translation grid for MoCA against MMSE scores. Functional Activities Questionnaire (FAQ) was evaluated as a strategy to separate dementia from MCI. Stepwise variable selection in logistic regression evaluated relative value of four test domains for separating MCI from HC. Methodsįor this cross-sectional study, we analyzed 219 healthy control (HC), 299 MCI, and 100 Alzheimer’s disease (AD) dementia cases from the Alzheimer’s Disease Neuroimaging Initiative (ADNI)-GO/2 database to evaluate MMSE and MoCA score distributions and select MoCA values to capture early and late MCI cases. Clinicians need to better understand the relationship between MoCA and MMSE scores. Only use the best score of either the serial 7 s or spelling WORLD backwards in the total MMSE score.The Montreal Cognitive Assessment (MoCA) was developed to enable earlier detection of mild cognitive impairment (MCI) relative to familiar multi-domain tests like the Mini-Mental State Exam (MMSE). If more or less then 5 letters are given, then one point is deducted for each extra or missing letter. One point is given for each letter spelled in the correct order backwards to a maximum score of five. WORLD should first be spelled forwards to allow the correction of any mistakes and then backwards. The total score is the maximum number of lines that can be drawn without crossing any lines. The line method involves drawing lines to match the letters from the correct response (DLROW) and the response given by the patient. With the creation of the Standardized MMSE (SMMSE), the proposed and easiest way to score WORLD is using the “line method” (see figure 1). Marshal Folstein advised that the score is “the number of letters in the correct order,” however, this often led to incorrect scoring due to the numerous possible permutations. Originally, the creator of the MMSE, psychiatrist Dr. Spelling WORLD backwards is straightforward, but the scoring of it is often incorrect, even by experienced clinicians. ![]()
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