Abstract
The
diagnostic accuracy of the short Montreal Cognitive Assessment
(s-MoCA), a cognitive screening instrument recently derived by item
response theory and computerized adaptive testing from the original
MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI)
was assessed in 2 patient cohorts referred to a dedicated memory clinic
in order to examine the validity and reproducibility of s-MoCA.
Diagnosis used standard clinical diagnostic criteria for dementia and
MCI as reference standard (prevalence of cognitive impairment = 0.43 and
0.46 in each cohort, respectively). There were significant differences
in s-MoCA test scores for dementia, MCI, and subjective memory
impairment (P ≤ .01), and s-MoCA effect sizes (Cohen d)
were medium to large (range: 0.65-1.42) for the diagnosis of dementia
and MCI. Using the cut-off for s-MoCA specified in the index study, it
proved highly sensitive (>0.9) for diagnosis of dementia but with
poor specificity (≤0.25), with moderate sensitivity (≥0.75) and
specificity (≥0.60) for diagnosis of MCI. In conclusion, in these
pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and
sensitive for the diagnosis of cognitive impairment in a memory clinic
setting, with a performance similar to that of the original MoCA.
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