A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores
A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores
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DOI：
10.1002/gps.4756
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发表时间：
2018-02-01
影响因子：
4
通讯作者：
Murphy, Kelly J.
中科院分区：
文献类型：
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作者：
Carson, Nicole;Leach, Larry;Murphy, Kelly J.
蒙特利尔认知评估(MoCA；Nasreddine et al.，2005)是一种认知筛查工具，旨在区分健康认知老化和轻度认知损害(MCI)。在不同的临床人群中，已经进行了几项关于MoCA的验证研究。一些研究表明，最初建议的26/30的临界值会导致假阳性率过高，特别是对于年龄较大和/或受教育程度较低的人。我们对文献进行了系统的回顾和荟萃分析，以确定MoCA在区分健康认知老化和可能的认知老化方面的诊断准确性。这些研究通过一系列临界值进行评估，以确定各自的敏感度、特异度、阳性和阴性预测准确性、阳性和阴性结果的似然比、分类准确性和Youden指数。结果荟萃分析显示，23/30的临界值在一系列参数中产生了最好的诊断准确性。结论MoCA临界值为23分，而不是最初推荐的26分，降低了假阳性率，并显示出总体上更好的诊断准确性。我们建议未来使用这个截止分数。版权所有(C)2017 John Wiley&Sons，Ltd.
ObjectiveThe Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) is a cognitive screening tool that aims to differentiate healthy cognitive aging from Mild Cognitive Impairment (MCI). Several validation studies have been conducted on the MoCA, in a variety of clinical populations. Some studies have indicated that the originally suggested cutoff score of 26/30 leads to an inflated rate of false positives, particularly for those of older age and/or lower education. We conducted a systematic review and meta-analysis of the literature to determine the diagnostic accuracy of the MoCA for differentiating healthy cognitive aging from possible MCI.MethodsOf the 304 studies identified, nine met inclusion criteria for the meta-analysis. These studies were assessed across a range of cutoff scores to determine the respective sensitivities, specificities, positive and negative predictive accuracies, likelihood ratios for positive and negative results, classification accuracies, and Youden indices.ResultsMeta-analysis revealed a cutoff score of 23/30 yielded the best diagnostic accuracy across a range of parameters.ConclusionsA MoCA cutoff score of 23, rather than the initially recommended score of 26, lowers the false positive rate and shows overall better diagnostic accuracy. We recommend the use of this cutoff score going forward. Copyright (c) 2017 John Wiley & Sons, Ltd.