title: MoCA cutoff score in relation to the functional assessment of seniors living in a rural Canadian community.
abstract: BACKGROUND
  Research suggests that the Montreal Cognitive Assessment (MoCA) normal cutoff score of 26 may not be appropriate for all populations and ages. We sought to determine an appropriate MoCA cutoff score for community-dwelling seniors living in a rural Canadian community.
  
  
  METHODS
  We conducted a retrospective chart review at a health centre in rural northern Ontario. The sample included community-dwelling seniors presenting between Dec. 1, 2013, and July 31, 2015. We generated a receiver operating characteristic curve to evaluate MoCA cutoff scores in relation to functional assessment, using the dichotomous categories of "no deficiencies in activities of daily living/instrumental activities of daily living (ADL/IADL) and "deficiencies in ADL/IADL."
  
  
  RESULTS
  A total of 95 charts were included in the chart review. We identified MoCA scores of 20 (sensitivity 85%, specificity 62%) and 21 (sensitivity 77%, specificity 77%) as cutoff scores for the identification of impairment in this rural population.
  
  
  CONCLUSIONS
  Our results suggest the normal range in MoCA score for the community-dwelling rural senior to be between 22 and 30. Although the MoCA demonstrated satisfactory performance as a screening measure, the importance of including ADL and IADL functional assessments before making clinical decisions cannot be overemphasized.
authors.affiliation: Health and Rehabilitation Sciences, University of Western Ontario, London, Ont.
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Doyon Dolinar
authors.affiliation: Espanola Regional Hospital and Health Centre, Espanola, Ont.
authors.forename: Bemice A
authors.initials: BA
authors.lastname: Pleta
authors.affiliation: Health and Rehabilitation Sciences, and School of Kinesiology, University of Western Ontario, London, Ont.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Salmoni
authors.affiliation: Health and Rehabilitation Sciences, and School of Health Studies, University of Western Ontario, London, Ont.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Johnson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012424:Rural Population; D012680:Sensitivity and Specificity