The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson's Disease.
OBJECTIVE
To explore whether the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) can be used to screen for dementia or mild cognitive impairment (MCI) in less educated patients with Parkinson's disease (PD).


METHODS
We reviewed the medical records of PD patients who had taken the Korean MMSE (K-MMSE), Korean MoCA (K-MoCA), and comprehensive neuropsychological tests. Predictive values of the K-MMSE and K-MoCA for dementia or MCI were analyzed in groups divided by educational level.


RESULTS
The discriminative powers of the K-MMSE and K-MoCA were excellent [area under the curve (AUC) 0.86-0.97] for detecting dementia but not for detecting MCI (AUC 0.64-0.85). The optimal screening cutoff values of both tests increased with educational level for dementia (K-MMSE < 15 for illiterate, < 20 for 0.5-3 years of education, < 23 for 4-6 years, < 25 for 7-9 years, and < 26 for 10 years or more; K-MoCA < 7 for illiterate, < 13 for 0.5-3 years, < 16 for 4-6 years, < 19 for 7-9 years, < 20 for 10 years or more) and MCI (K-MMSE < 19 for illiterate, < 26 for 0.5-3 years, < 27 for 4-6 years, < 28 for 7-9 years, and < 29 for 10 years or more; K-MoCA < 13 for illiterate, < 21 for 0.5-3 years, < 23 for 4-6 years, < 25 for 7-9 years, < 26 for 10 years or more).


CONCLUSIONS
Both MMSE and MoCA can be used to screen for dementia in patients with PD, regardless of educational level; however, neither test is sufficient to discriminate MCI from normal cognition without additional information.
Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ji In
JI
Kim
Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, Korea.
Mun Kyung
MK
Sunwoo
Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Young H
YH
Sohn
Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.|Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Phil Hyu
PH
Lee
Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jin Y
JY
Hong
Mini-Mental State Examination; Montreal Cognitive Assessment; Parkinson’s disease; dementia; mild cognitive impairment
Mov Disord. 2008 Jan 30;23(2):297-9
18044697
Mov Disord. 2010 Nov 15;25(15):2501-7
20878991
Mov Disord. 2008 May 15;23(7):1043-6
18381646
Mov Disord. 2007 Dec;22(16):2314-24
18098298
J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):745-52
2841426
Mov Disord. 2008 Apr 30;23(6):837-44
18307261
Arch Gerontol Geriatr. 2008 Nov-Dec;47(3):302-10
17936377
Arch Clin Neuropsychol. 2016 May;31(3):246-53
26891720
Arch Neurol. 1992 Aug;49(8):825-7
1524515
Parkinsonism Relat Disord. 2014 Nov;20(11):1145-8
25176439
Parkinsonism Relat Disord. 2014 Oct;20(10 ):1076-80
25085750
Neurology. 2010 Nov 9;75(19):1717-25
21060094
Neurology. 2009 Nov 24;73(21):1738-45
19933974
Mov Disord. 2012 Mar;27(3):349-56
22275317
Neurology. 2005 Dec 27;65(12):1863-72
16237129