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Comparison of the Short Test of Mental Status and the Montreal Cognitive Assessment Across the Cognitive Spectrum.

ABSTRACT: OBJECTIVE:To compare the Short Test of Mental Status (STMS) with the Montreal Cognitive Assessment (MoCA) for predicting and detecting mild cognitive impairment (MCI). PARTICIPANTS AND METHODS:Participants from the community-based Mayo Clinic Study of Aging (MCSA) (November 24, 2010, through May 19, 2012) and an academic referral Alzheimer's Disease Research Center (ADRC) (March 16, 2015, through September 5, 2018) were analyzed. All participants were evaluated using a standardized neuropsychological battery, and a multidisciplinary consensus diagnosis was assigned. The MCSA and ADRC samples included 313 and 106 stable cognitively normal (CN) participants, 72 and 8 CN participants at baseline who developed incident MCI or dementia, 114 and 96 participants with prevalent MCI, and 25 and 132 participants with dementia, respectively. RESULTS:There were no statistically significant differences between the 2 tests in 6 of 7 diagnostic comparisons across academic referral and community populations. The STMS had a better area under the curve (0.90; 95% CI, 0.87-0.93) for differentiating prevalent MCI from CN participants in the MCSA cohort compared with the MoCA cohort (0.85; 95% CI, 0.81-0.89; P=.01). In addition, 53% of the stable CN participants (222 of 419) scored less than 26 on the MoCA, with specificity of 47% for diagnosing prevalent MCI. CONCLUSION:We provide evidence that the STMS performs similarly to the MoCA in a variety of settings and neurodegenerative syndromes. These results suggest that the current recommended MoCA cutoff score may be overly sensitive, consistent with previous studies. We also provide a conversion table for comparing the 2 cognitive tests.

SUBMITTER: Townley RA

PROVIDER: S-EPMC6937135 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Comparison of the Short Test of Mental Status and the Montreal Cognitive Assessment Across the Cognitive Spectrum.

Townley Ryan A RA Syrjanen Jeremy A JA Botha Hugo H Kremers Walter K WK Aakre Jeremiah A JA Fields Julie A JA Machulda Mary M MM Graff-Radford Jonathan J Savica Rodolfo R Jones David T DT Knopman David S DS Petersen Ronald C RC Boeve Bradley F BF

Mayo Clinic proceedings 20190704 8

<h4>Objective</h4>To compare the Short Test of Mental Status (STMS) with the Montreal Cognitive Assessment (MoCA) for predicting and detecting mild cognitive impairment (MCI).<h4>Participants and methods</h4>Participants from the community-based Mayo Clinic Study of Aging (MCSA) (November 24, 2010, through May 19, 2012) and an academic referral Alzheimer's Disease Research Center (ADRC) (March 16, 2015, through September 5, 2018) were analyzed. All participants were evaluated using a standardize ...[more]

PMID: 31280871

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Project description:OBJECTIVES:While various short variants of the Montreal Cognitive Assessment (MoCA) have been developed, they have not been compared among each other to determine the most optimal variant for routine use. This study evaluated the comparative performance of the short variants in identifying mild cognitive impairment or dementia (MCI/dementia). DESIGN:Baseline data of a cohort study. SETTING:Alzheimer's Disease Centers across the United States. PARTICIPANTS:Participants aged ≥50 years (n = 4606), with median age 70 (interquartile range 65-76). MEASURES:Participants completed MoCA and were evaluated for MCI/dementia. The various short variants of MoCA were compared in their performance in discriminating MCI/dementia, using areas under the receiver operating characteristic curve (AUCs). RESULTS:All 7 short variants of MoCA had acceptable performance in discriminating MCI/dementia from normal cognition (AUC 87.7%-91.0%). However, only 2 variants by Roalf et al (2016) and Wong et al (2015) demonstrated comparable performance (AUC 88.4-88.9%) to the original MoCA (AUC 89.3%). Among the participants with higher education, only the variant by Roalf et al had similar AUC to the original MoCA. At the optimal cut-off score of <25, the original MoCA demonstrated 84.4% sensitivity and 76.4% specificity. In contrast, the short variant by Roalf et al had 87.2% sensitivity and 72.1% specificity at its optimal cut-off score of <13. CONCLUSIONS/IMPLICATIONS:The various short variants may not share similar diagnostic performance, with many limited by ceiling effects among participants with higher education. Only the short variant by Roalf et al was comparable to the original MoCA in identifying MCI or dementia even across education subgroups. This variant is one-third the length of the original MoCA and can be completed in <5 minutes. It provides a viable alternative when it is not feasible to administer the original MoCA in clinical practice and can be especially useful in nonspecialty clinics with large volumes of patients at high risk of cognitive impairment (such as those in primary care, geriatric, and stroke prevention clinics).

Dataset Information

Comparison of the Short Test of Mental Status and the Montreal Cognitive Assessment Across the Cognitive Spectrum.

Publications

Comparison of the Short Test of Mental Status and the Montreal Cognitive Assessment Across the Cognitive Spectrum.

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