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In the studies we reviewed, over 40% of people without dementia would have been incorrectly diagnosed with dementia using the MoCA. On the other hand, the test also produced a high proportion of false positives, that is people who did not have dementia but tested positive at the 'less than 26' cut-off. In the studies that used this cut-off, we found the test correctly detected over 94% of people with dementia in all settings. We found that MoCA was good at detecting dementia when using a recognised cut-off score of less than 26. There was a large variation in the way the different studies were carried out: therefore we chose to present the results in a narrative summary because a statistical summary (combining all the estimates into a summary sensitivity and specificity) would not have been meaningful. The proportion of people with dementia was 5% to 10% in two population-derived studies and 22% to 54% in the five clinic-based studies. There were a total 9422 people included in all 7 studies though only one study had more than 350 people. All studies included older people, with the youngest average age of 61 years in one study. There were three from memory clinics (specialist clinics where people are referred for suspected dementia), two from general hospital clinics, none from primary care and two studies carried out in the general population. We found seven studies that matched our criteria. The evidence we reviewed is current to August 2012. MoCA uses a series of questions to test different aspects of mental functioning.
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In this review, we wanted to discover whether using a well-established cognitive test, MoCA, could accurately detect dementia when compared to a gold standard diagnostic test. Mild Cognitive Impairment MoCA Montreal Cognitive Assessment cutoff scores diagnostic accuracy.We reviewed the evidence about the accuracy of the Montreal Cognitive Assessment (MoCA) test for detecting dementia.ĭementia is a common condition in older people, with at least 7% of people over 65 years old in the UK affected, and numbers are increasing worldwide. We recommend the use of this cutoff score going forward. Meta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters.Ī MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. These studies were assessed across a range of cutoff scores to determine the respective sensitivities, specificities, positive and negative predictive accuracies, likelihood ratios for positive and negative results, classification accuracies, and Youden indices. Of the 304 studies identified, nine met inclusion criteria for the meta-analysis.
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We conducted a systematic review and meta-analysis of the literature to determine the diagnostic accuracy of the MoCA for differentiating healthy cognitive aging from possible MCI. Some studies have indicated that the originally suggested cutoff score of 26/30 leads to an inflated rate of false positives, particularly for those of older age and/or lower education. Several validation studies have been conducted on the MoCA, in a variety of clinical populations. The Montreal Cognitive Assessment (MoCA Nasreddine et al., 2005) is a cognitive screening tool that aims to differentiate healthy cognitive aging from Mild Cognitive Impairment (MCI).