Evidence map›Paper›PMID 34607584›Full record

ArticleBMC psychiatry2021

A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study.

Xiaofang Jia, Zhihong Wang, Feifei Huang, Chang Su, Wenwen Du, Hongru Jiang, Huijun Wang, Jiaqi Wang, Fangjun Wang, Weiwu Su and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 407 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
407citing papers in PubMed, 10 pooled it
53.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

407 citing papers in PubMed, 10 syntheses or guidelines pooled it, 634 citations in OpenAlex.

  1. Pooled it
  2. Elevated neurofilament light chain (NfL) in blood and CSF as a biomarker for Parkinson's disease cognitive impairment: A meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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  16. The impact of transcranial direct current stimulation on brain network connectivity and topology in post-stroke cognitive impairment patients: a resting-state fMRI study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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347 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Xiaofang JiaNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Zhihong WangNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Feifei HuangNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Chang SuNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Wenwen DuNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Hongru JiangNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Huijun WangNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
Jiaqi WangSchool of Public Health, Hebei Medical University, Shijiazhuang, 050017, China.
Fangjun WangYongkang Center for Disease Control and Prevention, Yongkang, 321300, China.
Weiwu SuYuelu District Center for Disease Control and Prevention, Changsha, 410013, China.
Huifang XiaoChangde Center for Disease Control and Prevention, Changde, 415000, China.
Yanxin WangShaanxi Provincial Center for Disease Control and Prevention, Xian, 710054, China.
Bing ZhangNational Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China. zhangbing@chinacdc.cn.
Chinese Center For Disease Control and Prevention · CNHebei Medical University · CNHunan Provincial Center for Disease Control and Prevention · CNThe First People's Hospital of Changde · CNXian Center for Disease Control and Prevention · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to detect mild cognitive impairment (MCI) in population-based epidemiologic studies. However, their comparison on which is best suited to assess cognition is scarce in samples from multiple regions of China.

methodsWe conducted a cross-sectional analysis of 4923 adults aged ≥55 years from the Community-based Cohort Study on Nervous System Diseases. Objective cognition was assessed by Chinese versions of MMSE and MoCA, and total score and subscores of cognitive domains were calculated for each. Education-specific cutoffs of total score were used to diagnose MCI. Demographic and health-related characteristics were collected by questionnaires. Correlation and agreement for MCI between MMSE and MoCA were analyzed; group differences in cognition were evaluated; and multiple logistic regression model was used to clarify risk factors for MCI.

resultsThe overall MCI prevalence was 28.6% for MMSE and 36.2% for MoCA. MMSE had good correlation with MoCA (Spearman correlation coefficient = 0.8374, p < 0.0001) and moderate agreement for detecting MCI with Kappa value of 0.5973 (p < 0.0001). Ceiling effect for MCI was less frequent using MoCA versus MMSE according to the distribution of total score. Percentage of relative standard deviation, the measure of inter-individual variance, for MoCA (26.9%) was greater than for MMSE (19.0%) overall (p < 0.0001). Increasing age (MMSE: OR = 2.073 for ≥75 years; MoCA: OR = 1.869 for≥75 years), female (OR = 1.280 for MMSE; OR = 1.163 for MoCA), living in county town (OR = 1.386 and 1.862 for MMSE and MoCA, respectively) or village (OR = 2.579 and 2.721 for MMSE and MoCA, respectively), smoking (OR = 1.373 and 1.288 for MMSE and MoCA, respectively), hypertension (MMSE: OR = 1.278; MoCA: OR = 1.208) and depression (MMSE: OR = 1.465; MoCA: OR = 1.350) were independently associated with greater likelihood of MCI compared to corresponding reference group in both scales (all p < 0.05).

conclusionsMoCA is a better measure of cognitive function due to lack of ceiling effect and with good detection of cognitive heterogeneity. MCI prevalence is higher using MoCA compared to MMSE. Both tools identify concordantly modifiable factors for MCI, which provide important evidence for establishing intervention measures.

Indexed as

Cognitive DysfunctionAgedChinaCohort StudiesCross-Sectional StudiesFemaleHumansMental Status and Dementia TestsMental Status ScheduleMiddle AgedNeuropsychological TestsAgreementCorrelationMild cognitive impairmentMMSEMoCARisk factors

Identifiers

PMID34607584
PMCPMC8489046
OpenAlexW3204829872

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.