An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening

Clin Neuropsychol. 2015;29(4):413-25. doi: 10.1080/13854046.2015.1043349. Epub 2015 May 15.

Abstract

Objective: The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging.

Methods: 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures.

Results: Serial subtraction (Cramer's V = .408), delayed recall (Cramer's V = .702), and orientation items (Cramer's V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6% classification accuracy of the SF-MoCA, compared with 71.9% for the standard MoCA and 67.4% for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE.

Conclusions: Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.

Keywords: Alzheimer’s disease; Cognitive screening; Mild cognitive impairment; Montreal Cognitive Assessment.; Short form.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / psychology*
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / psychology
  • Cognition*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / psychology*
  • Dementia / diagnosis*
  • Dementia / psychology*
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Mental Recall
  • Middle Aged
  • Neuropsychological Tests / standards*
  • Orientation
  • Psychometrics
  • ROC Curve