The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment

Authors

  • Ziad S. Nasreddine MD,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Natalie A. Phillips PhD,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Valérie Bédirian BSc,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Simon Charbonneau MPS,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Victor Whitehead MSW,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Isabelle Collin PhD,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Jeffrey L. Cummings MD,

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • Howard Chertkow MD

    1. From the *Center for Clinical Research, Neurology Service, Hôpital Charles LeMoyne, Quebec, CanadaMemory Clinic Neuro Rive-Sud, Université de Sherbrooke, Quebec, CanadaBloomfield Center for Research in Aging, Lady Davis Institute, and §Department of Clinical Neurosciences and Division of Geriatric Medicine, Sir Mortimer B. Davis—Jewish General Hospital, McGill University and Division of Geriatric Medicine, Montreal, Quebec, CanadaResearch Center, University Institute of Geriatrics, University of Montreal, Montreal, Quebec, CanadaCenter for Research in Human Development/Department of Psychology, Concordia University, Montreal, Quebec, Canada#Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, CanadaDepartments of **Neurology††Psychiatry and Biobehavioral Sciences, David Gellen School of Medicine, University of California at Los Angeles, Los Angeles, California.
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  • This work was supported by the Canadian Institutes for Health Research, Société Alzheimer Rive-Sud, Longueuil, Quebec, Alzheimer Society of Canada, Valorization Recherche Québec (Consortium Cognition et Vieillissement), and Consortium of Canadian Centers for Clinical Cognitive Research.
    Dr. Chertkow is a national researcher of the Fonds de la recherche en Santé du Québec. Dr. Jeffrey L. Cummings is supported by a National Institute on Aging Alzheimer's Disease Center grant (AG 16570), an Alzheimer's disease Research Center of California grant, and the Sidell-Kagan Foundation.

Corresponding authors: Dr. Ziad S. Nasreddine, MD, FRCP(C), Neuro Rive-Sud Memory Clinic, 4896 Taschereau Boulevard Suite 250, Greenfield Park, Québec, Canada, J4V 2J2. E-mail: ziadn@sympatico.caDr. Howard Cherthow, MD, FRCP(C), Sir Mortimer B. Davis, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, Québec, Canada, H3T 1E2. E-mail: howard.chertkow@mcqill.ca

Abstract

Objectives: To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia.

Design: Validation study.

Setting: A community clinic and an academic center.

Participants: Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score≥17), and 90 healthy elderly controls (NC).

Measurements: The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD.

Results: Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively).

Conclusion: MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.

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