title: Multicenter Validation of an MMSE-MoCA Conversion Table.
abstract: BACKGROUND
  Accumulating evidence points to the superiority of the MoCA over the MMSE as a cognitive screening tool. To facilitate the transition from the MMSE to the MoCA in clinical and research settings, authors have developed MMSE-MoCA conversion tables. However, it is unknown whether a conversion table generated from Alzheimer's disease (AD) patients would apply to patients with other dementia subtypes like vascular dementia or frontotemporal dementia. Furthermore, the reliability and accuracy of MMSE-MoCA conversion tables has not been properly evaluated.
  
  
  METHODS
  We retrospectively examined the MMSE-MoCA relationship in a large multicenter sample gathered from 3 Memory Clinics in Quebec, Canada (1492 patients). We produced an MMSE-MoCA conversion table using the equi-percentile method with log-linear smoothing. We then cross-validated our conversion table with the ADNI dataset (1202 patients) and evaluated its accuracy for future predictions.
  
  
  RESULTS
  The MMSE-MoCA conversion table is consistent with previously published tables and has an intra-class correlation of 0.633 with the ADNI sample. However, we found that the MMSE-MoCA relationship is significantly modified by diagnosis (P < .01), with dementia subtypes associated with a dysexecutive syndrome showing a trend towards higher MMSE than other dementia syndromes for a given MoCA score. The large width of 95% confidence interval (CI) for a new prediction suggests questionable reliability for clinical use.
  
  
  CONCLUSIONS
  In this study, we validated a conversion table between MMSE and MoCA using a large multicenter sample. Our results suggest caution in interpreting the tables in heterogeneous clinical populations, as the MMSE-MoCA relationship may be different across dementia subtypes.
authors.affiliation: Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Québec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Bergeron
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Flynn
authors.affiliation: Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Québec, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Verret
authors.affiliation: Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Québec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Poulin
authors.affiliation: Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Québec, Canada.
authors.forename: Rémi W
authors.initials: RW
authors.lastname: Bouchard
authors.affiliation: Division of Neurology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
authors.forename: Christian
authors.initials: C
authors.lastname: Bocti
authors.affiliation: Division of Neurology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
authors.forename: Tamàs
authors.initials: T
authors.lastname: Fülöp
authors.affiliation: Division of Neurology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Lacombe
authors.affiliation: Alzheimer's Disease Research Unit/Memory Clinic, McGill Centre for Studies in Aging, Montreal, Quebec, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Gauthier
authors.affiliation: Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer, McGill University and Sherbrooke University, Montréal, Quebec, Canada.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Nasreddine
authors.affiliation: Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques du CHU de Québec, and Faculté de Médecine, Université Laval, Québec, Québec, Canada.
authors.forename: Robert Jr
authors.initials: RJ
authors.lastname: Laforce
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000209:etiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: 
  MMSE
  ; Cognitive screening; Conversion; MoCA