Wen Hong-Bo, Zhang Zhen-Xin, Niu Fu-Sheng, Li Ling
Department of Neurology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2008 Jan;47(1):36-9.
To study the distribution of Montreal cognitive assessment (MoCA) scores in terms of age and educational level in Chinese residents aged 50 years and over and to offer a benchmark for a cutoff score.
A total of 281 residents aged 50 years or older was drawn randomly in the urban areas of Beijing, including 215 healthy elderly controls (NC) and 66 patients meeting the clinical criteria of mild cognitive impairment (MCI). The final scores for MoCA were given in the form of mean percentage distributions specific for age, sex and educational level so as to compare the validity of MMSE mini-mental state examination and MoCA in detecting MCI. By a fitting multiple regression model the influence of the factors on MMSE and MoCA was assessed.
Using a cutoff score of 26, MMSE had a sensitivity of 24.2% to detect MCI, whereas MoCA detected 92.4% of the MCI subjects. We found a bivariate correlation between MoCA scores and both the factors of age and educational level (P < 0.001).
MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing normally on MMSE. Our adjustment in the cutoff scores would improve the detection of MCI and Alzheimer's disease by reducing the number of false negatives. MoCA scores should be used to identify current cognitive difficulties but not to make formal diagnoses.
研究50岁及以上中国居民蒙特利尔认知评估量表(MoCA)得分在年龄和教育水平方面的分布情况,并提供一个临界值的基准。
在北京城区随机抽取281名50岁及以上居民,其中包括215名健康老年对照(NC)和66名符合轻度认知障碍(MCI)临床标准的患者。MoCA的最终得分以年龄、性别和教育水平特定的平均百分比分布形式给出,以便比较简易精神状态检查表(MMSE)和MoCA在检测MCI方面的有效性。通过拟合多元回归模型评估各因素对MMSE和MoCA的影响。
采用26分的临界值,MMSE检测MCI的敏感性为24.2%,而MoCA检测出92.4%的MCI受试者。我们发现MoCA得分与年龄和教育水平因素均存在双变量相关性(P < 0.001)。
MoCA是一种简短的认知筛查工具,对于检测目前在MMSE表现正常的患者中概念化的MCI具有高敏感性和特异性。我们对临界值的调整将通过减少假阴性数量来改善MCI和阿尔茨海默病的检测。MoCA得分应用于识别当前的认知困难,但不能用于做出正式诊断。