title: Criterion and convergent validity of the Montreal cognitive assessment with screening and standardized neuropsychological testing.
abstract: OBJECTIVE
  To compare the validity of the Montreal Cognitive Assessment (MoCA) with the criterion standard of standardized neuropsychological testing and to compare the convergent validity of the MoCA with that of existing screening tools and global measures of cognition.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Tertiary care hospital-based cognitive neurology subspecialty clinic.
  
  
  METHODS
  A convenience sample of 107 individuals with mild Alzheimer's disease (AD, n=75) or mild cognitive impairment (MCI, n=32) from the Sunnybrook Dementia Study.
  
  
  METHODS
  In addition to the MoCA, all participants completed the Mini-Mental State Examination (MMSE), the Mattis Dementia Rating Scale (DRS), and detailed neuropsychological testing.
  
  
  RESULTS
  Convergent validity was supported, with MoCA scores correlating well with the MMSE (correlation coefficient (r)=0.66, P<.001) and the DRS (r=0.77, P<.001) and the MoCA better associated with the DRS than did the MMSE. Criterion validity was supported, with MoCA subscores according to cognitive domain correlating well with analogous neuropsychological tests and, in the case of memory (area under the receiver operating characteristic curve (AUC)=0.86), executive (AUC=0.79), and visuospatial function (AUC=0.79), being reasonably sensitive to impairment in those domains.
  
  
  CONCLUSIONS
  The MoCA is a valid assessment of cognition that shows good agreement with existing screening tools and global measures (convergent validity) and was superior to the MMSE in this regard. The MoCA domain-specific subscores align with performance on more-detailed neuropsychological tests, suggesting not only good criterion validity for the MoCA, but also that it may be useful in guiding further neuropsychological testing.
authors: Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Benjamin
authors: B
authors: Lam
authors: Heart and Stroke Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Laura E
authors: LE
authors: Middleton
authors: Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Mario
authors: M
authors: Masellis
authors: Ontario Brain Institute, Toronto, Ontario, Canada.
authors: Donald T
authors: DT
authors: Stuss
authors: L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Robin D
authors: RD
authors: Harry
authors: Clinical Epidemiology Unit, Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors: Alex
authors: A
authors: Kiss
authors: Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: Sandra E
authors: SE
authors: Black
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D015203:Reproducibility of Results
keywords: Mini-Mental Status Examination; Montreal Cognitive Assessment; neuropsychological testing; validation