![]() ![]() The Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) are commonly used cognitive screening scales ( 15). The National Health Commission of the People's Republic of China printed Exploring the Work Plan of the Special Service for the Prevention and Treatment of Dementia ( ), which aims to achieve 80% coverage of cognitive function screening in the elderly by 2022. However, in China, the government planned to establish a prevention and treatment service network for dementia. The fear, loss and stigma that are associated with dementia also discourage many patients from choosing cognitive assessments ( 14). Thus, community screening for MCI is a great challenge globally, and this is no different in China ( 12).Ĭonsidering that screening may lead to patients simply being treated for longer periods, with additional costs to the government but with no benefit to the patient, the United States Preventive Services Task Force and the UK National Screening Committee do not recommend dementia screening ( 5, 13). A range of cognitive assessment tasks that are sensitive to cognitive impairment are available, but many are domain specific and time-consuming in actual clinical practice ( 11). Although the National Institute on Aging and Alzheimer's Association (NIA-AA) created an AT(N) diagnosis scheme ( 8, 9), these biomarkers are expensive and invasive ( 10) and cannot be used widely for screening. Thus, MCI has become a novel topic in current research.Īlthough timely diagnosis is important, distinguishing MCI from normal age-related cognitive decline is a challenging task for clinicians ( 3, 5, 7). If the progression of MCI to dementia could be delayed by 5 years, the prevalence of dementia would drop by 43% by 2050 ( 1). With the progress of technology and the development of a social civilization, several interventions, such as combined cognitive and physical exercise ( 4), have already been shown to be more effective in preventing greater reductions in cognition early in the course of the disease ( 5, 6). Although MCI is associated with a high risk of dementia, it sometimes remains normal or slightly decreases cognitive function without any notable interference in daily life activities ( 3). Mild cognitive impairment (MCI) is a transitional level between the normal state of the brain and dementia ( 2), and the prevalence of MCI in adults aged ≥ 65 years is 10–20%. By 2050, 115 million people will have dementia ( 1). With an aging population, the number of patients with dementia has increased worldwide. However, the MMSE has advantage over MoCA in screening MCI in individuals with lower education levels and the older groups of Chinese elderly. For MMSE in the above four groups, the cutoff scores to detect MCI were 26.5, 22.5, 28.5 and 26.5, respectively, and the optimal cutoff scores for dementia were 23.5, 19.5, 23.5 and 23.5, respectively.Ĭonclusion: Compared to MMSE, the MoCA is more suitable for discriminating MCI in younger and more highly educated elderly Chinese individuals. Results: The area under the curve(AUC) of the MoCA (0.82) for detecting MCI was significantly higher than that of the MMSE (0.75) ( P 75 years old and education ≤ 6 years, aged ≤ 75 years old and education > 6 years, aged > 75 years old and education > 6 years in screening for MCI were identified as 19.5, 15.5, 24.5 and 24.5, respectively, and the optimal cutoff scores for dementia were 18.5, 10.5, 18.5 and 20.5, respectively. Furthermore, comparison of ROC curves were made to evaluate the performances of the two tests. The optimal cutoffs for MoCA and MMSE were determined using receiver operating characteristic (ROC) analysis among the different age and education levels in the three groups. Methods: A total of 2,954 Chinese elderly individuals, including 1,746 normal controls, 599 MCI patients and 249 dementia patients, were consecutively recruited in the study. The present study aimed to investigate the ability of the MOCA and MMSE to differentiate between cognitively normal elderly individuals, MCI patients and dementia patients at different ages and education levels and to establish the optimal cutoff scores of the MoCA and MMSE for MCI and dementia in the Chinese elderly. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Chinaīackground: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used tools for cognitive impairment screening.Shaowei Zhang † Qi Qiu † Shixing Qian Xiang Lin Feng Yan Lin Sun Shifu Xiao Jinghua Wang * Yuan Fang * Xia Li *
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