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      About Neurodegenerative Diseases: 3.0 Impact Factor I 4.3 CiteScore I 0.695 Scimago Journal & Country Rank (SJR)

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      Normative Data for the Montreal Cognitive Assessment in a Japanese Community-Dwelling Older Population

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          Abstract

          Background: Although the Montreal Cognitive Assessment (MoCA) is acknowledged as a promising neuropsychological tool, its normative data for older populations have not been established yet. The purpose of this study was to provide normative data for the MoCA in Japanese community-dwelling older people. Methods: In a Japanese town, 1,977 participants aged 65 years or older (mean age 73.6 years; male 41.3%) completed MoCA tests. After descriptive and regression analyses, normative data were developed for MoCA scores in the population. Results: The mean MoCA score observed (21.8 points) was lower than that for normal controls (27.4 points) in the original validation study of the MoCA. Additionally, 82.6% of MoCA scores fell below the standard cutoff of 26 points for detecting mild cognitive impairment (MCI). The regression analysis showed that higher age and fewer years of formal education were associated with lower MoCA scores (p < 0.001). Normative data for MoCA scores were presented with respect to age and education. Conclusion: This study provided normative data for the MoCA in a Japanese community-dwelling older population. This research also suggests that conventional use of the MoCA as a screening tool for MCI might be problematic in cultures different from that in which the cutoff was developed.

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          Population-based norms for the Mini-Mental State Examination by age and educational level.

          R Crum, J C Anthony, S S Bassett … (1993)
          To report the distribution of Mini-Mental State Examination (MMSE) scores by age and educational level. National Institute of Mental Health Epidemiologic Catchment Area Program surveys conducted between 1980 and 1984. Community populations in New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Calif. A total of 18,056 adult participants selected by probability sampling within census tracts and households. Summary scores for the MMSE are given in the form of mean, median, and percentile distributions specific for age and educational level. The MMSE scores were related to both age and educational level. There was an inverse relationship between MMSE scores and age, ranging from a median of 29 for those 18 to 24 years of age, to 25 for individuals 80 years of age and older. The median MMSE score was 29 for individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooling. Cognitive performance as measured by the MMSE varies within the population by age and education. The cause of this variation has yet to be determined. Mini-Mental State Examination scores should be used to identify current cognitive difficulties and not to make formal diagnoses. The results presented should prove to be useful to clinicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new studies in which cognitive status is a variable of interest.
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            The MoCA: well-suited screen for cognitive impairment in Parkinson disease.

            J. Dalrymple-Alford, M. R. MacAskill, C. T. Nakas … (2010)
            To establish the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) when screening externally validated cognition in Parkinson disease (PD), by comparison with a PD-focused test (Scales for Outcomes in Parkinson disease-Cognition [SCOPA-COG]) and the standardized Mini-Mental State Examination (S-MMSE) as benchmarks. A convenience sample of 114 patients with idiopathic PD and 47 healthy controls was examined in a movement disorders center. The 21 patients with dementia (PD-D) were diagnosed using Movement Disorders Society criteria, externally validated by detailed independent functional and neuropsychological tests. The 21 patients with mild cognitive impairment (PD-MCI) scored 1.5 SD or more below normative data in at least 2 measures in 1 of 4 cognitive domains. Other patients had normal cognition (PD-N). Primary outcomes using receiver operating characteristic (ROC) curve analyses showed that all 3 mental status tests produced excellent discrimination of PD-D from patients without dementia (area under the curve [AUC], 87%-91%) and PD-MCI from PD-N patients (AUC, 78%-90%), but the MoCA was generally better suited across both assessments. The optimal MoCA screening cutoffs were <21/30 for PD-D (sensitivity 81%; specificity 95%; negative predictive value [NPV] 92%) and <26/30 for PD-MCI (sensitivity 90%; specificity 75%; NPV 95%). Further support that the MoCA is at least equivalent to the SCOPA-COG, and superior to the S-MMSE, came from the simultaneous classification of the 3 PD patient groups (volumes under a 3-dimensional ROC surface, chance = 17%: MoCA 79%, confidence interval [CI] 70%-89%; SCOPA-COG 74%, CI 62%-86%; MMSE-Sevens item 56%, CI 44%-68%; MMSE-World item 62%, CI 50%-73%). The MoCA is a suitably accurate, brief test when screening all levels of cognition in PD.
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              Frequency and course of mild cognitive impairment in a multiethnic community.

              Yaakov Stern, Nicole Schupf, Ming Tang … (2008)
              To examine incidence rates and antecedents of mild cognitive impairment (MCI) and Alzheimer's disease (AD) among diverse elders without dementia at the initial visit, and to examine the characteristics of elders with MCI who reverted to normal on follow-up examination. A total of 2,364 Caribbean Hispanic, black, or non-Hispanic white subjects, aged 65 or older, who were free of dementia at initial evaluation were followed up every 18 to 24 months. Incidence rate of MCI and AD was determined by examination of neurological, medical, psychiatric, and neuropsychological function. Over 10,517 person-years, 21% of normal elderly subjects progressed to MCI (annual incidence rate, 5.1%; 95% confidence interval, 4.6-5.6%). Of those with MCI initially, 21.8% were subsequently diagnosed with AD (annual incidence rate, 5.4%; 95% confidence interval, 4.7-6.3%), 47% remained unchanged, and 31% reverted to normal. Those with MCI were 2.8 times more likely to experience development of AD than normal elderly subjects. MCI with impairment in memory and at least one other cognitive domain was associated with greatest risk for progression to AD and was also least likely to revert to normal at follow-up. Consistent diagnosis of MCI or incident probable or possible AD was 60% sensitive and 94% specific for the pathological diagnosis of AD. Impaired memory and language were useful predictors of transition to AD. Reversion to normal from MCI was frequent, but those with impairment in more than one cognitive domain were more likely to progress or remain impaired than those with single-domain impairment. Clinical diagnosis of MCI does not always predict AD neuropathology.
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                Author and article information

                Journal
                Journal ID (publisher-id): NED
                Journal ID (nlm-ta): Neuroepidemiology
                Journal ID (doi): 10.1159/issn.0251-5350
                Title: Neuroepidemiology
                Publisher: S. Karger AG
                ISSN (Print): 0251-5350
                ISSN (Electronic): 1423-0208
                Publication date Subscription-year: 2013
                Publication date (Print): December 2012
                Publication date (Electronic): 11 October 2012
                Volume: 40
                Issue: 1
                Pages: 23-29
                Affiliations
                aGraduate School of Human-Environment Studies and bInstitute of Health Science, Kyushu University, and cBiostatistics Center, Kurume University, Fukuoka, Japan
                Author notes
                *Dr. Shuzo Kumagai, Institute of Health Science, Kyushu University, 6-1 Kasugakoen, Kasuga, Fukuoka 816-8580 (Japan), Tel. +81 92 583 7853, E-Mail shuzo@ihs.kyushu-u.ac.jp
                Article
                Publisher ID: 339753 Other ID: Neuroepidemiology 2013;40:23–29
                DOI: 10.1159/000339753
                PubMed ID: 23075757
                SO-VID: c03b3996-bc51-4288-8e64-e7ca62ef5b5f
                Copyright © © 2012 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 01 March 2012
                Date accepted : 28 May 2012
                Page count
                Figures: 2, Tables: 1, Pages: 7
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Keywords: Cognitive decline,Dementia,Cognitive screening,Mild cognitive impairment,Cross-sectional study,Community-based study,Elderly
                Data availability:
                ScienceOpen disciplines: Geriatric medicine, Neurology, Cardiovascular Medicine, Neurosciences, Clinical Psychology & Psychiatry, Public health
                Keywords: Cognitive decline, Dementia, Cognitive screening, Mild cognitive impairment, Cross-sectional study, Community-based study, Elderly

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