![]() Therefore, this study aimed to confirm the effect of education on MoCA compared to MMSE in Korean elderly, many of whom had low education. 19 Although the number of highly educated elderly is increasing in Korea, it is clear that administering MoCA for the elderly with low education in the dementia field has far more cases in Korea than in Western countries. 12, 13, 16, 17, 18 According to data from the Ministry of Health and Welfare, only 17.2% of older Koreans in 2008 and 34% in 2020 have had a high school or higher education. Indeed, studies conducted in Western countries using the MoCA and MMSE have shown that participants have an average of 14–15 years of education, 9, 14, 15 while studies conducted in Korea show an average education level of 5–8 years. In other words, since the MoCA includes difficult items that elderly individuals with low educational attainment cannot perform well, it can be predicted that if the MoCA is conducted for elderly people with low educational attainment, it will not be different from the discriminability of the MMSE, which consists of relatively easy items. The researchers suggested that this was because the level of education of the elderly in Korea was lower than that of the elderly who participated in foreign studies. However, another domestic study 13 did not find a significant difference in discriminating vascular MCI from normal elderly individuals between the MoCA and MMSE. 10, 11Ī domestic study 12 also reported that the MoCA was more useful than MMSE in discriminating between normal elderly and amnestic MCI. 3, 4 Many studies have reported that the MoCA is superior to the MMSE in detecting MCI 5, 6, 7, 8, 9 and vascular cognitive impairment. It includes more subtests for assessing frontal and executive function than the Mini-Mental State Examination (MMSE). 2 It is one of the representative screening tests used in clinical settings. 10.The Montreal Cognitive Assessment (MoCA) 1 was developed as a screening test for mild cognitive impairment (MCI). Aging Clinical and Experimental Research, 29(6), 1113–1120. Montreal Cognitive Assessment (MoCA) optimal cut-off scores for people with probable Alzheimer’s disease and with probable cognitive impairment. The Clinical Neuropsychologist, 25(1), 119–126. Psychometric evaluation of the Montreal Cognitive Assessment (MoCA) in three diverse samples. Misreported schooling, multiple measures and returns to educational qualifications. War Department, Adjutant Generals’ Office.īattistin E, De Nadai M, & Sianesi B (2014). Position statement on use of race as a factor in neuropsychology test norming and performance prediction.Īrmy Individual Test Battery. Relevance 2050 Subcommittee on Use of Race in Neuropsychological test Norming and Performance Prediction. These findings highlight the need for racially stratified population-based norms given the high misclassification of Black participants without such adjustment.Ĭognitive aging MoCA cognitive screening diagnosis and classification disparities race.Īmerican Academy of Clinical Neuropsychology (AACN). We suggest cutoff scores of ≤25/30 be applied to White persons and ≤22/30 for Black persons. Classification statistics are presented.īlack participants were misclassified at a higher rate than White participants when applying the ≤26/30 cutoff score. Our sample was highly educated therefore, we did not observe significant differences in scores when accounting for education across race. In contrast, this criterion correctly classified 40.5% of Black cognitively normal participants and 90.8% of Black MCI participants. ![]() Sensitivity and specificity analyses revealed that when using the cutoff score of ≤26/30, the MoCA correctly classified 73.2% of White cognitively normal participants and 83.1% of White MCI participants. Based on NACC's classification, participants were either cognitively normal ( n = 3,650) or MCI ( n = 1,108). Participants were predominately White (82.8%) and female (61.7%) with a mean age of 69.3 years ( SD = 10.3) and education level of 16.3 years ( SD = 2.6). The purpose of this study is to investigate the potential influence of race on MoCA classification cutoff score accuracy.ĭata were obtained from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set and yielded 4,758 total participants. However, previously suggested cutoff scores of 26/30 and above is often criticized and lacks racial diversity. The Montreal Cognitive Assessment (MoCA) is a common cognitive screener for detecting mild cognitive impairment (MCI). ![]()
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