ArticleAlzheimer's & dementia (Amsterdam, Netherlands)
Comparative methods for determining MoCA, MMSE, and CDR cut-offs in Alzheimer's disease: insights from the ADNI study.
Article in Alzheimer's & dementia (Amsterdam, Netherlands). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Abstract
introductionAccurate cut-off values for the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) are essential for detecting and staging Alzheimer's disease-related cognitive impairment. Prior studies often relied on a single statistical method, potentially misaligning thresholds with clinical priorities.
methodsWe analyzed cognitive assessments from 883 Alzheimer's Disease Neuroimaging Initiative participants classified as cognitively normal, mild cognitive impairment (MCI), or clinical impairment (CI). Optimal thresholds were identified using Euclidean distance, Index of Union, maximum product of sensitivity and specificity, and Youden's J Index. Sensitivity, specificity, and area under the curve were calculated.
resultsFor MCI, MoCA cut-offs were 24 (three methods) and 25 (Youden's J Index). For CI, MoCA cut-offs were 17 (Youden's J Index) and 18 (others). MMSE (28, 24) and CDR (0.5, 1) cut-offs were consistent. DISCUSSION: MoCA thresholds vary by method, requiring context-specific selection, while MMSE and CDR cut-offs remain stable.
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