title: Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study.
abstract: BACKGROUND
  We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study.
  
  
  METHODS
  This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI.
  
  
  RESULTS
  A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91-0.97) vs. 0.91 (95% CI = 0.86-0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80).
  
  
  CONCLUSIONS
  Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.
authors.affiliation: Department of Pharmacology, National University of Singapore, Singapore.
authors.forename: YanHong
authors.initials: Y
authors.lastname: Dong
authors.forename: Wah
authors.initials: W
authors.lastname: Yean Lee
authors.forename: Saima
authors.initials: S
authors.lastname: Hilal
authors.forename: Monica
authors.initials: M
authors.lastname: Saini
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Christopher Li-Hsian
authors.initials: CL
authors.lastname: Chen
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Venketasubramanian
authors.forename: Mohammad Kamran
authors.initials: MK
authors.lastname: Ikram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity