Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity

• Main Authors: Sadaf Arefi Milani, Michael Marsiske, Linda B. Cottler, Xinguang Chen, Catherine W. Striley
• Format: Article
• Language: English
• Published: Wiley 2018-01-01
• Series: Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring
• Subjects: Alzheimer's disease; Dementia; Montreal Cognitive Assessment; Screening; Race; Ethnicity
• Online Access: https://doi.org/10.1016/j.dadm.2018.09.003
• ISSN: 2352-8729

Abstract Introduction The Montreal Cognitive Assessment (MoCA), scored from 0 to 30, is used as a screening tool for mild cognitive impairment (MCI). The current cutoff (26) may not be optimal among minorities. Methods Data from the National Alzheimer's Coordinating Center Uniform Data Set March 2018 data freeze was used to calculate optimal cutoffs for detection of MCI and dementia by race/ethnic group and education. Results Of the 3895 individuals included, 80.7% were non‐Hispanic White, 15.0% were non‐Hispanic Black, and 4.2% were Hispanic. Optimal cutoffs for detection of MCI were 25 among non‐Hispanic Whites, 24 among Hispanics, and 23 among non‐Hispanic Blacks. Optimal cutoffs for detection of dementia were 19 among non‐Hispanic Whites and 16 for both non‐Hispanic Blacks and Hispanics. Lower educational attainment produced lower optimal cutoffs. Discussion Our findings suggest cutoffs may need to be stratified by race/ethnicity and education to ensure detecting MCI from normal and MCI from dementia.