Validation of the Czech Montreal Cognitive Assessment for Mild Cognitive Impairment due to Alzheimer Disease and Czech Norms in 1,552 Elderly Persons

Dement Geriatr Cogn Disord. 2018;46(5-6):335-345. doi: 10.1159/000494489. Epub 2018 Dec 4.

Abstract

Background: The Czech version of the Montreal Cognitive Assessment (MoCA-CZ) and delayed recall of 5 words have not been validated in patients with mild cognitive impairment (MCI) due to Alzheimer disease (AD) and compared to norms of a large population.

Method: The MoCA-CZ was administered to 1,600 elderly individuals in 2 groups consisting of 48 patients with MCI due to AD (AD-MCI) and 1,552 normal elderly adults.

Results: MoCA-CZ scores were significantly lower in the AD-MCI patients than in the normal elderly (21 ± 4 vs. 26 ± 3 points; p = 0.03). Under the recommended cutoff score of ≤25, the MoCA-CZ demonstrated an excellent sensitivity of 94% but a low specificity of 62%. When the score was reduced to ≤24, the MoCA-CZ showed an optimal sensitivity of 87% for AD-MCI and a specificity of 72%. Normal elderly persons should recall at least 2 words after delay (sensitivity 80%, specificity 74%). Several cutoff points were derived from normative data stratified by age and education.

Conclusions: The cutoff for AD-MCI and stratified norms are available for the MoCA total score and delayed recall of the Czech version. The cut-off scores of the MoCA-CZ, sensitivity, and specificity are lower than in the original study.

Keywords: Alzheimer disease; Cutoff; Dementia; Mild cognitive impairment; Montreal Cognitive Assessment; Norm; Screening; Validation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / complications
  • Alzheimer Disease* / psychology
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / etiology
  • Czech Republic
  • Female
  • Humans
  • Male
  • Mental Recall*
  • Mental Status and Dementia Tests*
  • Neuropsychological Tests
  • Reproducibility of Results
  • Self Concept
  • Sensitivity and Specificity
  • Translating