Kim Haeyoon, Yu Kyung-Ho, Kang Yeonwook
Department of Psychology, Hallym University, Chuncheon, Korea.
Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Dement Neurocogn Disord. 2024 Oct;23(4):236-244. doi: 10.12779/dnd.2024.23.4.236. Epub 2024 Oct 29.
Since the onset of the coronavirus disease 2019 pandemic, the Telephone-Montreal Cognitive Assessment (T-MoCA) has gained popularity as a remote cognitive screening tool. T-MoCA includes items from the original MoCA (MoCA-30), excluding those requiring visual stimuli, resulting in a maximum score of 22 points. This study aimed to assess whether the T-MoCA items (MoCA-22) demonstrate comparable discriminatory power to MoCA-30 and Mini-Mental State Examination (MMSE) in screening for mild cognitive impairment (MCI) and dementia.
Participants included 233 cognitively normal (CN) individuals, 175 with MCI, and 166 with dementia. All completed the Korean-MoCA-30 (K-MoCA-30) and Korean-MMSE (K-MMSE), with the Korean-MoCA-22 (K-MoCA-22) scores derived from the K-MoCA-30 responses. A receiver operating characteristic (ROC) curve analysis was conducted.
K-MoCA-22 showed a strong correlation with K-MoCA-30 and a moderate correlation with K-MMSE. Scores decreased progressively from CN to MCI and dementia, with significant differences between groups, consistent with K-MoCA-30 and K-MMSE. The study also explored modified K-MoCA-22 index scores across 5 cognitive domains. ROC curve analysis revealed that the area under the curve (AUC) for K-MoCA-22 was significantly smaller than that for K-MoCA-30 in distinguishing both MCI and dementia from CN. However, no significant difference in AUC was found between K-MoCA-22 and K-MMSE, indicating similar discriminatory power. Additionally, the discriminability of K-MoCA-22 varied by education level.
These results indicate that K-MoCA-22, although slightly less effective than K-MoCA-30, still shows good to excellent discriminatory power and is comparable to K-MMSE in screening for MCI and dementia.
自2019年冠状病毒病大流行开始以来，电话蒙特利尔认知评估量表（T-MoCA）作为一种远程认知筛查工具受到了广泛欢迎。T-MoCA包含原始蒙特利尔认知评估量表（MoCA-30）中的项目，但不包括那些需要视觉刺激的项目，最高分为22分。本研究旨在评估T-MoCA项目（MoCA-22）在筛查轻度认知障碍（MCI）和痴呆症时是否具有与MoCA-30及简易精神状态检查表（MMSE）相当的鉴别能力。
参与者包括233名认知正常（CN）个体、175名患有MCI的个体以及166名患有痴呆症的个体。所有人都完成了韩国版MoCA-30（K-MoCA-30）和韩国版MMSE（K-MMSE），K-MoCA-22分数根据K-MoCA-30的回答得出。进行了受试者操作特征（ROC）曲线分析。
K-MoCA-22与K-MoCA-30呈强相关，与K-MMSE呈中度相关。分数从CN到MCI和痴呆症逐渐降低，组间存在显著差异，这与K-MoCA-30和K-MMSE一致。该研究还探讨了5个认知领域的改良K-MoCA-22指数分数。ROC曲线分析显示，在区分MCI和痴呆症与CN方面，K-MoCA-22的曲线下面积（AUC）显著小于K-MoCA-30。然而，K-MoCA-22和K-MMSE之间的AUC没有显著差异，表明鉴别能力相似。此外，K-MoCA-22的鉴别能力因教育水平而异。
这些结果表明，K-MoCA-22虽然比K-MoCA-30稍欠效力，但在筛查MCI和痴呆症时仍显示出良好至优异的鉴别能力，且与K-MMSE相当。
