title: Optimal cutoff scores for dementia and mild cognitive impairment of the Montreal Cognitive Assessment among elderly and oldest-old Chinese population.
abstract: BACKGROUND
  All versions of the Montreal Cognitive Assessment (MoCA) lack population-based data of 80-plus individuals. The norms and cut-off scores for mild cognitive impairment (MCI) and dementia of the MoCA are different among five Chinese versions.
  
  
  OBJECTIVE
  To provide the cut-off scores in detecting MCI and dementia of the Peking Medical Union College Hospital version of the MoCA (MoCA-P).
  
  
  METHODS
  In a cross-sectional survey, Chinese veterans aged ≥60 years completed the MoCA-P and the Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Among 7,445 elderly veterans, 5,085 (68.30%) were aged ≥80 years old, 2,621 (35.20%) had 6 years of education or less, 6,847 (91.97%) were male, and 2,311 (31.04%) and 984 (13.22%) veterans were diagnosed as having MCI and dementia, respectively. Adding two points and one point to the MoCA scores for the primary and middle school groups, respectively, can fully adjust for the notable impact of education but cannot compensate for the effect of age. In the three age groups (60-79, 80-89, and ≥90 years old), the optimal MoCA-P cut-off scores for detecting MCI were ≤25, ≤24, and ≤23, respectively, and for detecting dementia were ≤24, ≤21, and ≤19, respectively, which demonstrated relatively high sensitivities and specificities. The areas under the curves for the MoCA-P for detecting MCI and dementia (0.937 and 0.908, respectively) were greater than those for the MMSE (0.848 and 0.892, respectively).
  
  
  CONCLUSIONS
  Compared with the MMSE, the MoCA-P is significantly better for detecting MCI in the elderly, particularly in the oldest old population, and it also displays more effectiveness in detecting dementia.
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, P.R. China.
authors.forename: Ji-ping
authors.initials: JP
authors.lastname: Tan
authors.affiliation: Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, P.R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Beijing, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, P.R. China.
authors.forename: Lu-ning
authors.initials: LN
authors.lastname: Wang
authors.affiliation: Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, P.R. China.
authors.forename: Yi-ming
authors.initials: YM
authors.lastname: Zhao
authors.affiliation: Department of Gerontology, Bethune International Peace Hospital, Shijiazhuang, P.R. China.
authors.forename: Bao-cheng
authors.initials: BC
authors.lastname: Yu
authors.affiliation: Department of Neurology, Chinese PLA 201 Hospital, Dalian, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Du
authors.affiliation: Department of Gerontology, Changhai Hospital, Shanghai, P.R. China.
authors.forename: Wen-jun
authors.initials: WJ
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Chinese PLA 401 Hospital, Qingdao, P.R. China.
authors.forename: Lian-qi
authors.initials: LQ
authors.lastname: Cui
authors.affiliation: Department of Neurology, General Hospital of Chengdu Military Command, Chengdu, P.R. China.
authors.forename: Qing-song
authors.initials: QS
authors.lastname: Wang
authors.affiliation: Department of Neurology, Chinese PLA 323 Hospital, Xi'an, P.R. China.
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Department of Neurology, General Hospital of Lanzhou Military Command, Lanzhou, P.R. China.
authors.forename: Jin-sheng
authors.initials: JS
authors.lastname: Yang
authors.affiliation: Department of Neurology, Chinese PLA 107 Hospital, Yantai, P.R. China.
authors.forename: Jian-min
authors.initials: JM
authors.lastname: Yu
authors.affiliation: First Cadre Department, Fuzhou General Hospital of Nanjing Military Command, Fuzhou, P.R. China.
authors.forename: Xiang-nan
authors.initials: XN
authors.lastname: Xia
authors.affiliation: Forth Cadre Department, General Hospital of Guangzhou Military Command, Guangzhou, P.R. China.
authors.forename: Pei-yi
authors.initials: PY
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D019540:Area Under Curve; D002681:China / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity
keywords: Dementia; Mini-Mental State Examination; Montreal Cognitive Assessment; elderly; mild cognitive impairment; oldest old