title: An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening.
abstract: OBJECTIVE
  The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging.
  
  
  METHODS
  408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures.
  
  
  RESULTS
  Serial subtraction (Cramer's V = .408), delayed recall (Cramer's V = .702), and orientation items (Cramer's V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6% classification accuracy of the SF-MoCA, compared with 71.9% for the standard MoCA and 67.4% for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE.
  
  
  CONCLUSIONS
  Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.
authors.affiliation: a Department of Psychiatry , The University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Horton
authors.forename: Linda S
authors.initials: LS
authors.lastname: Hynan
authors.forename: Laura H
authors.initials: LH
authors.lastname: Lacritz
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Rossetti
authors.forename: Myron F
authors.initials: MF
authors.lastname: Weiner
authors.forename: C Munro
authors.initials: CM
authors.lastname: Cullum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology*; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D009949:Orientation; D011594:Psychometrics; D012372:ROC Curve
keywords: Alzheimer’s disease; Cognitive screening; Mild cognitive impairment; Montreal Cognitive Assessment.; Short form