Author:
Thomann Alessandra E.,Berres Manfred,Goettel Nicolai,Steiner Luzius A.,Monsch Andreas U.
Abstract
Abstract
Background
The Montreal Cognitive Assessment (MoCA) has good sensitivity for mild cognitive impairment, but specificity is low when the original cut-off (25/26) is used. We aim to revise the cut-off on the German MoCA for its use in clinical routine.
Methods
Data were analyzed from 496 Memory Clinic outpatients (447 individuals with a neurocognitive disorder; 49 with cognitive normal findings) and from 283 normal controls. Cut-offs were identified based on (a) Youden’s index and (b) the 10th percentile of the control group.
Results
A cut-off of 23/24 on the MoCA had better correct classification rates than the MMSE and the original MoCA cut-off. Compared to the original MoCA cut-off, the cut-off of 23/24 points had higher specificity (92% vs 63%), but lower sensitivity (65% vs 86%). Introducing two separate cut-offs increased diagnostic accuracies with 92% specificity (23/24 points) and 91% sensitivity (26/27 points). Scores between these two cut-offs require further examinations.
Conclusions
Using two separate cut-offs for the MoCA combined with scores in an indecisive area enhances the accuracy of cognitive screening.
Publisher
Springer Science and Business Media LLC
Subject
Cognitive Neuroscience,Clinical Neurology,Neurology
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