title: Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.
abstract: OBJECTIVE
  Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points.
  
  
  METHODS
  A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC).
  
  
  RESULTS
  ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767).
  
  
  CONCLUSIONS
  MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ciesielska
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Remigiusz
authors.initials: R
authors.lastname: Sokołowski
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Mazur
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Marta
authors.initials: M
authors.lastname: Podhorecka
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Anna
authors.initials: A
authors.lastname: Polak-Szabela
authors.affiliation: Katedra i Klinika Geriatrii, Collegium Medicum, Uniwersytet Mikołaja Kopernika, Bydgoszcz.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kędziora-Kornatowska
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007361:Intelligence Tests / Q000592:standards*; D008297:Male; D008403:Mass Screening; D016743:Mental Competency; D008609:Mental Status Schedule / Q000592:standards*; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment
keywords: Mini-Mental; Montreal Cognitive Assessment; State Examination; mild cognitive impairment