Differential Validity of K-MoCA-22 Compared to K-MoCA-30 and K-MMSE for Screening MCI and Dementia.

Dementia and neurocognitive disorders Pub Date : 2024-10-01 Epub Date: 2024-10-29 DOI:10.12779/dnd.2024.23.4.236
Haeyoon Kim, Kyung-Ho Yu, Yeonwook Kang
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Abstract

Background and purpose: Since the onset of the coronavirus disease 2019 pandemic, the Telephone-Montreal Cognitive Assessment (T-MoCA) has gained popularity as a remote cognitive screening tool. T-MoCA includes items from the original MoCA (MoCA-30), excluding those requiring visual stimuli, resulting in a maximum score of 22 points. This study aimed to assess whether the T-MoCA items (MoCA-22) demonstrate comparable discriminatory power to MoCA-30 and Mini-Mental State Examination (MMSE) in screening for mild cognitive impairment (MCI) and dementia.

Methods: Participants included 233 cognitively normal (CN) individuals, 175 with MCI, and 166 with dementia. All completed the Korean-MoCA-30 (K-MoCA-30) and Korean-MMSE (K-MMSE), with the Korean-MoCA-22 (K-MoCA-22) scores derived from the K-MoCA-30 responses. A receiver operating characteristic (ROC) curve analysis was conducted.

Results: K-MoCA-22 showed a strong correlation with K-MoCA-30 and a moderate correlation with K-MMSE. Scores decreased progressively from CN to MCI and dementia, with significant differences between groups, consistent with K-MoCA-30 and K-MMSE. The study also explored modified K-MoCA-22 index scores across 5 cognitive domains. ROC curve analysis revealed that the area under the curve (AUC) for K-MoCA-22 was significantly smaller than that for K-MoCA-30 in distinguishing both MCI and dementia from CN. However, no significant difference in AUC was found between K-MoCA-22 and K-MMSE, indicating similar discriminatory power. Additionally, the discriminability of K-MoCA-22 varied by education level.

Conclusions: These results indicate that K-MoCA-22, although slightly less effective than K-MoCA-30, still shows good to excellent discriminatory power and is comparable to K-MMSE in screening for MCI and dementia.

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K-MoCA-22 与 K-MoCA-30 和 K-MMSE 在筛查 MCI 和痴呆症方面的差异有效性。
背景和目的:自 2019 年冠状病毒疾病大流行以来,电话-蒙特利尔认知能力评估(T-MoCA)作为一种远程认知能力筛查工具广受欢迎。T-MoCA 包括原 MoCA(MoCA-30)中的项目,但不包括需要视觉刺激的项目,因此最高分为 22 分。本研究旨在评估T-MoCA项目(MoCA-22)在筛查轻度认知障碍(MCI)和痴呆症方面是否表现出与MoCA-30和迷你精神状态检查(MMSE)相当的鉴别力:参与者包括 233 名认知能力正常 (CN) 的个体、175 名 MCI 患者和 166 名痴呆症患者。所有人都完成了韩国-MoCA-30(K-MoCA-30)和韩国-MMSE(K-MMSE),其中韩国-MoCA-22(K-MoCA-22)的得分来自于 K-MoCA-30 的反应。结果显示,K-MoCA-22 显示出很强的预测能力:结果:K-MoCA-22 与 K-MoCA-30 呈较强相关性,与 K-MMSE 呈中等相关性。从 CN 到 MCI 和痴呆,得分逐渐下降,组间差异显著,与 K-MoCA-30 和 K-MMSE 一致。研究还探讨了 5 个认知领域的修正 K-MoCA-22 指数得分。ROC 曲线分析显示,在区分 MCI 和痴呆与 CN 方面,K-MoCA-22 的曲线下面积(AUC)明显小于 K-MoCA-30。但是,K-MoCA-22 和 K-MMSE 的 AUC 没有明显差异,这表明两者具有相似的鉴别力。此外,K-MoCA-22 的判别能力因教育水平而异:这些结果表明,在筛查 MCI 和痴呆症方面,K-MoCA-22 虽然略逊于 K-MoCA-30,但仍显示出良好至卓越的鉴别力,与 K-MMSE 不相上下。
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