title: Effectiveness of Montreal Cognitive Assessment for the diagnosis of mild cognitive impairment and mild Alzheimer's disease in Singapore.
abstract: BACKGROUND
  Mild cognitive impairment (MCI) is an important clinical entity with significant management implications. However, traditional screening tools lack the sensitivity needed to detect amnestic MCI (MCI-A). Montreal Cognitive Assessment (MoCA) has yet to be validated for the diagnosis of MCI in a multiracial society such as Singapore. We thus aimed to study the effectiveness of MoCA for the diagnosis of MCI-A in the Singapore population.
  
  
  METHODS
  Data on patients with MCI-A and mild Alzheimer's disease (AD) was obtained from a prospectively collected clinical database between January 2008 and January 2011. Patients with no cognitive impairment (NCI) were recruited from among the spouses and friends of patients attending the memory clinic.
  
  
  RESULTS
  There were a total of 212 participants (103 NCI, 49 MCI-A, 60 mild AD). For the diagnosis of MCI-A, a MoCA score of < 26 for patients with ≤ 10 years of education, and a score of < 27 for patients with > 10 years of education provided a sensitivity of > 94%. For the diagnosis of mild AD, a MoCA score of < 24 for patients with ≤ 10 years of education, and a score of < 25 for patients with > 10 years of education provided a sensitivity of > 85%.
  
  
  CONCLUSIONS
  In the Singapore population, we recommend cutoff scores of 26/27 and 24/25 be used to detect MCI-A and mild AD, respectively, when using MoCA. For patients with ≤ 10 years of education, a +1 point correction is needed.
authors.affiliation: Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433. Nagaendran_Kandiah@nni.com.sg.
authors.forename: Amanda
authors.initials: A
authors.lastname: Ng
authors.forename: Ivane
authors.initials: I
authors.lastname: Chew
authors.forename: Kaavya
authors.initials: K
authors.lastname: Narasimhalu
authors.forename: Nagaendran
authors.initials: N
authors.lastname: Kandiah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000628:therapy; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D016208:Databases, Factual; D003906:Developing Countries; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012846:Singapore