University of Arizona College of Medicine Phoenix Campus, Phoenix, AZ, USA.
Dement Geriatr Cogn Disord. 2011;31(2):126-31. doi: 10.1159/000323867. Epub 2011 Jan 29.
To perform an item analysis of the Montreal Cognitive Assessment (MoCA) versus the Mini-Mental State Examination (MMSE) in the prediction of cognitive impairment, and to examine the characteristics of different MoCA threshold scores.
135 subjects enrolled in a longitudinal clinicopathologic study were administered the MoCA by a single physician and the MMSE by a trained research assistant. Subjects were classified as cognitively impaired or cognitively normal based on independent neuropsychological testing.
89 subjects were found to be cognitively normal, and 46 cognitively impaired (20 with dementia, 26 with mild cognitive impairment). The MoCA was superior in both sensitivity and specificity to the MMSE, although not all MoCA tasks were of equal predictive value. A MoCA threshold score of 26 had a sensitivity of 98% and a specificity of 52% in this population. In a population with a 20% prevalence of cognitive impairment, a threshold of 24 was optimal (negative predictive value 96%, positive predictive value 47%).
This analysis suggests the potential for creating an abbreviated MoCA. For screening in primary care, the MoCA threshold of 26 appears optimal. For testing in a memory disorders clinic, a lower threshold has better predictive value.
对蒙特利尔认知评估（MoCA）与简易精神状态检查（MMSE）在预测认知障碍方面进行项目分析，并探讨不同 MoCA 截断分数的特点。
对 135 例参加纵向临床病理研究的受试者，由一名医生进行 MoCA 检查，由一名受过培训的研究助理进行 MMSE 检查。根据独立的神经心理学测试，将受试者分为认知正常或认知障碍。
89 例受试者认知正常，46 例认知障碍（20 例痴呆，26 例轻度认知障碍）。MoCA 在敏感性和特异性方面均优于 MMSE，尽管并非所有 MoCA 任务都具有同等的预测价值。在该人群中，MoCA 截断分数为 26 时具有 98%的敏感性和 52%的特异性。在认知障碍患病率为 20%的人群中，截断分数为 24 时最佳（阴性预测值 96%，阳性预测值 47%）。
该分析表明创建简化 MoCA 的潜力。对于初级保健中的筛查，MoCA 截断分数 26 似乎是最佳的。对于记忆障碍诊所中的测试，较低的截断分数具有更好的预测价值。
