The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.
OBJECTIVE
To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia.


METHODS
Validation study.


METHODS
A community clinic and an academic center.


METHODS
Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC).


METHODS
The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD.


RESULTS
Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively).


CONCLUSIONS
MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
Nasreddine
Ziad S
ZS
Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, Canada. ziadn@sympatico.ca
Phillips
Natalie A
NA
Bédirian
Valérie
V
Charbonneau
Simon
S
Whitehead
Victor
V
Collin
Isabelle
I
Cummings
Jeffrey L
JL
Chertkow
Howard
H
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics; D011792:Quebec; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity