22 Citations (Scopus)

Abstract

Objective: The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging. Methods: 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures. Results: Serial subtraction (Cramer’s V = .408), delayed recall (Cramer’s V = .702), and orientation items (Cramer’s V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6% classification accuracy of the SF-MoCA, compared with 71.9% for the standard MoCA and 67.4% for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE. Conclusions: Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.

Original languageEnglish (US)
JournalClinical Neuropsychologist
DOIs
StateAccepted/In press - May 16 2015

Fingerprint

Dementia
ROC Curve
Alzheimer Disease
Psychometrics
Montreal
Screening
Cognitive Dysfunction
Mental State
Receiver Operating Characteristic

Keywords

  • Alzheimer’s disease
  • Cognitive screening
  • Mild cognitive impairment
  • Montreal Cognitive Assessment.
  • Short form

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Developmental and Educational Psychology

Cite this

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title = "An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening",
abstract = "Objective: The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging. Methods: 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures. Results: Serial subtraction (Cramer’s V = .408), delayed recall (Cramer’s V = .702), and orientation items (Cramer’s V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6{\%} classification accuracy of the SF-MoCA, compared with 71.9{\%} for the standard MoCA and 67.4{\%} for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE. Conclusions: Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.",
keywords = "Alzheimer’s disease, Cognitive screening, Mild cognitive impairment, Montreal Cognitive Assessment., Short form",
author = "Horton, {Daniel K.} and Hynan, {Linda S.} and Lacritz, {Laura H.} and Rossetti, {Heidi C.} and Weiner, {Myron F.} and Cullum, {C. Munro}",
year = "2015",
month = "5",
day = "16",
doi = "10.1080/13854046.2015.1043349",
language = "English (US)",
journal = "Clinical Neuropsychologist",
issn = "0920-1637",
publisher = "Swets & Zeitlinger",

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TY - JOUR

T1 - An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening

AU - Horton, Daniel K.

AU - Hynan, Linda S.

AU - Lacritz, Laura H.

AU - Rossetti, Heidi C.

AU - Weiner, Myron F.

AU - Cullum, C. Munro

PY - 2015/5/16

Y1 - 2015/5/16

N2 - Objective: The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging. Methods: 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures. Results: Serial subtraction (Cramer’s V = .408), delayed recall (Cramer’s V = .702), and orientation items (Cramer’s V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6% classification accuracy of the SF-MoCA, compared with 71.9% for the standard MoCA and 67.4% for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE. Conclusions: Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.

AB - Objective: The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging. Methods: 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures. Results: Serial subtraction (Cramer’s V = .408), delayed recall (Cramer’s V = .702), and orientation items (Cramer’s V = .832) were included in the SF-MoCA based on largest effect sizes in item analyses. Results revealed 72.6% classification accuracy of the SF-MoCA, compared with 71.9% for the standard MoCA and 67.4% for the MMSE. Results of NRI analyses and ROC curve comparisons revealed that classification accuracy of the SF-MoCA was comparable to the standard version and generally superior to the MMSE. Conclusions: Findings suggest the SF-MoCA could be an effective brief tool in detecting cognitive impairment.

KW - Alzheimer’s disease

KW - Cognitive screening

KW - Mild cognitive impairment

KW - Montreal Cognitive Assessment.

KW - Short form

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