Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment
BackgroundThe Montreal Cognitive Assessment (MoCA) is one of the most widely-used cognitive screening instruments and has been translated into several different languages and dialects. Although the original validation study suggested to use a cutoff of ≤26, subsequent studies have shown that lower c...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-02-01
|
| Series: | Frontiers in Psychology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1369766/full |
| _version_ | 1797315978899488768 |
|---|---|
| author | Michael Malek-Ahmadi Michael Malek-Ahmadi Nia Nikkhahmanesh |
| author_facet | Michael Malek-Ahmadi Michael Malek-Ahmadi Nia Nikkhahmanesh |
| author_sort | Michael Malek-Ahmadi |
| collection | DOAJ |
| description | BackgroundThe Montreal Cognitive Assessment (MoCA) is one of the most widely-used cognitive screening instruments and has been translated into several different languages and dialects. Although the original validation study suggested to use a cutoff of ≤26, subsequent studies have shown that lower cutoff values may yield fewer false-positive indications of cognitive impairment. The aim of this study was to summarize the diagnostic accuracy and mean difference of the MoCA when comparing cognitively unimpaired (CU) older adults to those with amnestic mild cognitive impairment (aMCI).MethodsPubMed and EMBASE databases were searched from inception to 22 February 2022. Meta-analyses for area under the curve (AUC) and standardized mean difference (SMD) values were performed.ResultsFifty-five observational studies that included 17,343 CU and 8,413 aMCI subjects were selected for inclusion. Thirty-nine studies were used in the AUC analysis while 44 were used in the SMD analysis. The overall AUC value was 0.84 (95% CI: 0.81, 0.87) indicating good diagnostic accuracy and a large effect size was noted for the SMD analysis (Hedge’s g = 1.49, 95% CI: 1.33, 1.64). Both analyses had high levels of between-study heterogeneity. The median cutoff score for identifying aMCI was <24.Discussion and conclusionThe MoCA has good diagnostic accuracy for detecting aMCI across several different languages. The findings of this meta-analysis also support the use of 24 as the optimal cutoff when the MoCA is used to screen for suspected cognitive impairment. |
| first_indexed | 2024-03-08T03:11:42Z |
| format | Article |
| id | doaj.art-530a366245934889ba34922667c362ed |
| institution | Directory Open Access Journal |
| issn | 1664-1078 |
| language | English |
| last_indexed | 2024-03-08T03:11:42Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj.art-530a366245934889ba34922667c362ed2024-02-13T04:17:45ZengFrontiers Media S.A.Frontiers in Psychology1664-10782024-02-011510.3389/fpsyg.2024.13697661369766Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairmentMichael Malek-Ahmadi0Michael Malek-Ahmadi1Nia Nikkhahmanesh2Banner Alzheimer’s Institute, Phoenix, AZ, United StatesCollege of Medicine, University of Arizona, Phoenix, AZ, United StatesCollege of Medicine, University of Arizona, Phoenix, AZ, United StatesBackgroundThe Montreal Cognitive Assessment (MoCA) is one of the most widely-used cognitive screening instruments and has been translated into several different languages and dialects. Although the original validation study suggested to use a cutoff of ≤26, subsequent studies have shown that lower cutoff values may yield fewer false-positive indications of cognitive impairment. The aim of this study was to summarize the diagnostic accuracy and mean difference of the MoCA when comparing cognitively unimpaired (CU) older adults to those with amnestic mild cognitive impairment (aMCI).MethodsPubMed and EMBASE databases were searched from inception to 22 February 2022. Meta-analyses for area under the curve (AUC) and standardized mean difference (SMD) values were performed.ResultsFifty-five observational studies that included 17,343 CU and 8,413 aMCI subjects were selected for inclusion. Thirty-nine studies were used in the AUC analysis while 44 were used in the SMD analysis. The overall AUC value was 0.84 (95% CI: 0.81, 0.87) indicating good diagnostic accuracy and a large effect size was noted for the SMD analysis (Hedge’s g = 1.49, 95% CI: 1.33, 1.64). Both analyses had high levels of between-study heterogeneity. The median cutoff score for identifying aMCI was <24.Discussion and conclusionThe MoCA has good diagnostic accuracy for detecting aMCI across several different languages. The findings of this meta-analysis also support the use of 24 as the optimal cutoff when the MoCA is used to screen for suspected cognitive impairment.https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1369766/fullcognitive screenmild cognitive impairmentcognitively unimpaireddiagnostic accuracycutoff score |
| spellingShingle | Michael Malek-Ahmadi Michael Malek-Ahmadi Nia Nikkhahmanesh Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment Frontiers in Psychology cognitive screen mild cognitive impairment cognitively unimpaired diagnostic accuracy cutoff score |
| title | Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| title_full | Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| title_fullStr | Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| title_full_unstemmed | Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| title_short | Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| title_sort | meta analysis of montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment |
| topic | cognitive screen mild cognitive impairment cognitively unimpaired diagnostic accuracy cutoff score |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1369766/full |
| work_keys_str_mv | AT michaelmalekahmadi metaanalysisofmontrealcognitiveassessmentdiagnosticaccuracyinamnesticmildcognitiveimpairment AT michaelmalekahmadi metaanalysisofmontrealcognitiveassessmentdiagnosticaccuracyinamnesticmildcognitiveimpairment AT nianikkhahmanesh metaanalysisofmontrealcognitiveassessmentdiagnosticaccuracyinamnesticmildcognitiveimpairment |