Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging

David R. Roalf; Paul J. Moberg; Sharon X. Xie; David A. Wolk; Stephen T. Moelter; Steven E. Arnold; Alan T Murray

doi:10.1016/j.jalz.2012.10.001

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Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging

Journal article

Open access

Peer reviewed

Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging

David R. Roalf, Paul J. Moberg, Sharon X. Xie, David A. Wolk, Stephen T. Moelter, Steven E. Arnold and Alan T Murray

Alzheimer's & dementia, v 9(5), pp 529-537

Sep 2013

DOI: https://doi.org/10.1016/j.jalz.2012.10.001

PMID: 23260866

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Abstract

Alzheimer's disease

Diagnostic accuracy

Mild cognitive impairment

MMSE

MoCA

The aim of this study was to compare the utility and diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in the diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) in a clinical cohort. Three hundred twenty-one AD, 126 MCI, and 140 older adults with healthy cognition (HC) were evaluated using the MMSE, the MoCA, a standardized neuropsychologic battery according to the Consortium to Establish a Registry of Alzheimer's Disease (CERAD-NB), and an informant-based measure of functional impairment, the Dementia Severity Rating Scale (DSRS). Diagnostic accuracy and optimal cut-off scores were calculated for each measure, and a method for converting MoCA to MMSE scores is presented. The MMSE and MoCA offer reasonably good diagnostic and classification accuracy as compared with the more detailed CERAD-NB; however, as a brief cognitive screening measure, the MoCA was more sensitive and had higher classification accuracy for differentiating MCI from HC. Complementing the MMSE or the MoCA with the DSRS significantly improved diagnostic accuracy. The findings support recent data indicating that the MoCA is superior to the MMSE as a global assessment tool, particularly in discerning earlier stages of cognitive decline. In addition, we found that overall diagnostic accuracy improves when the MMSE or MoCA is combined with an informant-based functional measure. Finally, we provide a reliable and easy conversion of MoCA to MMSE scores. However, the need for MCI-specific measures is still needed to increase the diagnostic specificity between AD and MCI.

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Details

Title: Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging
Creators: David R. Roalf - University of Pennsylvania
Paul J. Moberg - University of Pennsylvania
Sharon X. Xie - University of Pennsylvania
David A. Wolk - University of Pennsylvania
Stephen T. Moelter - Department of Behavioral and Social Sciences University of the Sciences Philadelphia PA USA
Steven E. Arnold - University of Pennsylvania
Alan T Murray
Publication Details: Alzheimer's & dementia, v 9(5), pp 529-537
Publisher: Elsevier
Resource Type: Journal article
Language: English
Web of Science ID: WOS:000324724500006
Scopus ID: 2-s2.0-84883560471
Other Identifier: 991019357634904721

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Collaboration types: Domestic collaboration
Web of Science research areas: Clinical Neurology