The diagnosis decision was made independent of MoCA-BC scores. Given the importance and popularity of MoCA-BC for clinical application, this study was aimed at exploring the capacity and examining the accuracy of MoCA-BC and its two subtests (MoCA-BC-MIS and MoCA-BC-NM) in discrimination of NC, MCI, mild and moderate AD.Īll subjects received complete neurological and neuropsychological assessments, brain imaging, and other necessary laboratory tests. The latter subtest was a novel creation for the present study and was devised to describe cognitive domains other than episodic memory. 21 The Non-memory Index Score of MoCA-BC (MoCA-BC-NM) was calculated by adding the score of orientation, calculation, animal naming, and verbal fluency (the number of fruits listed), with a score ranging from 0 to 15 likewise. This scoring method was designed to better detect the encoding memory deficit. 20 The Memory Index Score of MoCA-BC (MoCA-BC-MIS) was calculated by adding the number of words remembered in free delayed recall, category-cued recall, and multiple choice-cued recall multiplied by 3, 2, and 1, respectively, with a score ranging from 0 to 15. 19, 20 However, with the progression of the disease, the frontal executive networks were also involved 1, 20 and caused encoding memory deficit that did not improve with cueing. 16 – 18 In the early phase of MCI, executive functions were preserved as a compensation for hippocampal dysfunction. ![]() Many studies have shown that patients with MCI, who subsequently declined to AD, were first impaired in delayed recall memory. The present study aimed to find out whether MoCA-BC or its subtests could be applied as a preliminary screening method to distinguish among outpatients with MCI, mild and moderate AD as a substitute for MMSE. However, no relevant research has been conducted concerning MoCA-BC in staging dementia severity. 15 The MoCA-BC, given its sensitivity to non-memory cognitive domains such as executive function, 5, 10 should be better suited for detecting more severe disease states. 14 To save time and avoid duplicate tests, the MOCA-BC had been observed to be frequently used in clinics in China as a replacement of MMSE due to convenience and higher screening efficiency. In addition, epidemiological studies have found that MoCA was superior to MMSE as a brief and feasible assessment tool, particularly in discerning earlier stages of cognitive decline. 13 Our previous study determined the optimal cutoff scores for MCI screening among different education groups, and recognized the MoCA-BC as a more sensitive and accurate scale in screening for MCI compared to the mini-mental state examination (MMSE). 9 – 11 Since education level had been found to affect MoCA scores, 2, 12 the optimal cutoff points of the MOCA-BC for screening for MCI were developed based on it as well. The Chinese version of the MoCA-B (MOCA-BC), translated with cultural modifications from the original English version, has shown excellent validity and accuracy in screening for MCI in the Chinese elderly. ![]() ![]() ![]() As for AD detection, cutoff points were also demonstrated differently ranging from a minimum of 14 6 to a maximum of 26 9 all over the world. For instance, Bosco et al 6 reported a minimum cutoff of 17 to detect MCI in Italy, while Ng et al 7 as well as Tu et al 8 suggested a maximum cutoff of 27 appropriate for Singaporean and Chinese. Comparisons between healthy controls and subjects with MCI or AD conducted in several international validation studies reported diverse cutoff points, sensitivity and specificity values. However, the application of MoCA to discriminate patients with MCI and Alzheimer’s Disease (AD) showed wide differences in thresholds due to cultural differences across regions. 1 – 4 A revised MoCA test called the MoCA basic (MoCA-B) was devised to screen for MCI in a group of individuals with little education. Montreal Cognitive Assessment (MoCA) has been widely used as a screening test for detection of mild cognitive impairment (MCI) in the highly educated elderly with an average education level of 13 years.
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