Department of Psychiatry, Neurological Institute, Veterans General Hospital, Taipei, Taiwan.
Int Psychogeriatr. 2012 Apr;24(4):651-8. doi: 10.1017/S1041610211002298. Epub 2011 Dec 12.
The Montreal Cognitive Assessment (MoCA) is an instrument for screening mild cognitive impairment (MCI). This study examined the psychometric properties and the validity of the Taiwan version of the MoCA (MoCA-T) in an elderly outpatient population.
Participants completed the MoCA-T, Mini-Mental State Examination (MMSE), and the Chinese Version Verbal Learning Test. The diagnosis of Alzheimer's disease (AD) was made based on the NINCDS-ADRDA criteria, and MCI was diagnosed through the criteria proposed by Petersen et al. (2001).
Data were collected from 207 participants (115 males/92 females, mean age: 77.3 ± 7.5 years). Ninety-eight participants were diagnosed with AD, 71 with MCI, and 38 were normal controls. The area under the receiver operator curves (AUC) for predicting AD was 0.98 (95% confidence interval [CI] = 0.97-1.00) for the MMSE, and 0.99 (95% CI = 0.98-1.00) for the MoCA-T. The AUC for predicting MCI was 0.81 (95% CI = 0.72-0.89) using the MMSE and 0.91 (95% CI = 0.86-1.00) using the MoCA-T. Using an optimal cut-off score of 23/24, the MoCA-T had a sensitivity of 92% and specificity of 78% for MCI. Item response theory analysis indicated that the level of information provided by each subtest of the MoCA-T was consistent. The frontal and language subscales provided higher discriminating power than the other subscales in the detection of MCI.
Compared to the MMSE, the MoCA-T provides better psychometric properties in the detection of MCI. The utility of the MoCA-T is optimal in mild to moderate cognitive dysfunction.
蒙特利尔认知评估（MoCA）是一种用于筛查轻度认知障碍（MCI）的工具。本研究在老年门诊人群中考察了 MoCA 台湾版（MoCA-T）的心理测量特性和有效性。
参与者完成了 MoCA-T、简易精神状态检查（MMSE）和汉语版词语学习测验。根据 NINCDS-ADRDA 标准诊断阿尔茨海默病（AD），根据 Petersen 等人（2001 年）提出的标准诊断 MCI。
共收集了 207 名参与者的数据（115 名男性/92 名女性，平均年龄：77.3±7.5 岁）。98 名参与者被诊断为 AD，71 名参与者被诊断为 MCI，38 名参与者为正常对照。MMSE 预测 AD 的受试者工作特征曲线（AUC）下面积为 0.98（95%置信区间 [CI] = 0.97-1.00），MoCA-T 的 AUC 为 0.99（95%CI = 0.98-1.00）。MMSE 预测 MCI 的 AUC 为 0.81（95%CI = 0.72-0.89），MoCA-T 的 AUC 为 0.91（95%CI = 0.86-1.00）。使用最佳截断值 23/24，MoCA-T 对 MCI 的敏感度为 92%，特异性为 78%。项目反应理论分析表明，MoCA-T 各子测验提供的信息量一致。在检测 MCI 时，额叶和语言分量表比其他分量表具有更高的辨别力。
与 MMSE 相比，MoCA-T 在检测 MCI 方面具有更好的心理测量特性。MoCA-T 在轻度至中度认知功能障碍时的效用最佳。
