Question 146

Question In adults with cognitive impairment or memory problems how effective is the MoCA (Montreal Cognitive Assessment) compared to the MMSE (Mini Mental State Examination) in memory management / managing cognitive impairment? Evidence from six diagnostic test accuracy studies indicated that the MoCA is likely to perform as well as or better than the MMSE for the diagnosis of cognitive impairment in a variety of relevant populations. There was also evidence to suggest that the MoCA could be used with a higher diagnostic threshold to maximise sensitivity for screening applications. Evidence from one study, which analysed the association of individual components of MoCA and MMSE with cognitive impairment, indicated that there may be potential to develop a brief instrument which could have better diagnostic performance than either MoCA or MMSE; further research in this area may be useful. What does the evidence say? Number of included studies/reviews (number of participants) We identified six diagnostic test accuracy studies which compared the performance of the MoCA (Montreal Cognitive Assessment) to that of the MMSE (Mini Mental State Examination for diagnosing cognitive impairment, as defined by neuropsychological testing. One study also assessed the performance of the ACE-R (Addenbrooke's Cognitive Examination–Revised) score. 6 Two studies used a disgnostic case-control design; these studies compared the ability of MMSE and MoCA to distinguish between mild cognitive impairment (MCI) and healthy controls or AD and healthy controls, 2 and between behavioural frontotemporal dementia (bv-FTD) and healthy controls. 3 The