Cognitive Function Tests: Application of MMSE and MoCA in Various Clinical Settings- a Brief Overview
DOI:
https://doi.org/10.12775/QS.2024.34.56285Keywords
Neuropsychological Tests, Cognition, Mental Status and Dementia Test, Cognition Disorders, DementiaAbstract
Introduction:
Cognitive impairment can emerge as part of aging or from conditions affecting brain function, such as stroke, brain tumors, delirium, and neurodegenerative diseases. Effective cognitive assessment in clinical practice requires brief, reliable tests that evaluate specific cognitive domains. The MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) are among the most frequently used tools for these evaluations, each offering unique insights.
Purpose of Research:
This study aims to compare the effectiveness of MMSE and MoCA in diagnosing cognitive impairment and determining their suitability in various clinical settings and patient profiles.
Materials and Methods:
The analysis includes 61 articles from databases such as PubMed and Scopus, identified using keywords: Neuropsychological Tests, Cognitive Function Tests, MMSE and MoCA.
Basic Results:
The results indicate that MMSE, while effective for initial dementia screening, is less sensitive to mild cognitive impairment and influenced by education and age. MoCA offers higher sensitivity for MCI and early Alzheimer's stages, making it valuable as a complementary tool to MMSE.
Conclusions:
Combining MMSE and MoCA assessments can enhance diagnostic accuracy across diverse clinical contexts. Each tool’s unique strengths contribute to a more comprehensive cognitive assessment approach, optimizing diagnostic strategies for specific patient needs.
References
Harvey PD. Domains of cognition and their assessment. Dialogues Clin Neurosci. 2019;21(3).
Slater H, Young J. A review of brief cognitive assessment tests. Vol. 23, Reviews in Clinical Gerontology. 2013.
Ismail Z, Rajji TK, Shulman KI. Brief cognitive screening instruments: An update. Vol. 25, International Journal of Geriatric Psychiatry. 2010.
Velayudhan L, Ryu SH, Raczek M, Philpot M, Lindesay J, Critchfield M, et al. Review of brief cognitive tests for patients with suspected dementia. Vol. 26, International Psychogeriatrics. 2014.
Tsoi KKF, Chan JYC, Hirai HW, Wong SYS, Kwok TCY. Cognitive tests to detect dementia a systematic review and meta-analysis. JAMA Intern Med. 2015;175(9).
Harvan JR, Cotter V. An evaluation of dementia screening in the primary care setting. J Am Acad Nurse Pract. 2006;18(8).
Bravo G, Hébert R. Age- and education-specific reference values for the mini-mental and modified mini-mental state examinations derived from a non-demented elderly population. Int J Geriatr Psychiatry. 1997;12(10).
Scazufca M, Almeida OP, Vallada HP, Tasse WA, Menezes PR. Limitations of the Mini-mental state examination for screening dementia in a community with low socioeconomic status : RResults from the Sao Paulo Ageing& health study. Eur Arch Psychiatry Clin Neurosci. 2009;259(1).
Ciesielska N, Sokołowski R, Mazur E, Podhorecka M, Polak-Szabela A, Kędziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol. 2016;50(5).
Jia X, Wang Z, Huang F, Su C, Du W, Jiang H, et al. 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. BMC Psychiatry. 2021 Dec 1;21(1).
Pinto TCC, Machado L, Bulgacov TM, Rodrigues-Júnior AL, Costa MLG, Ximenes RCC, et al. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly? Vol. 31, International Psychogeriatrics. Cambridge University Press; 2019. p. 491–504.
Chun CT, Seward K, Patterson A, Melton A, Macdonald-Wicks L. Evaluation of available cognitive tools used to measure mild cognitive decline: A scoping review. Vol. 13, Nutrients. 2021.
Arevalo-Rodriguez I, Smailagic N, Roquéi Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, et al. Mini-Mental State Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people with mild cognitive impairment (MCI). Vol. 2015, Cochrane Database of Systematic Reviews. 2015.
Mitchell AJ, Shukla D, Ajumal HA, Stubbs B, Tahir TA. The Mini-Mental State Examination as a diagnostic and screening test for delirium: Systematic review and meta-analysis. Gen Hosp Psychiatry. 2014;36(6).
Burdick DJ, Cholerton B, Watson GS, Siderowf A, Trojanowski JQ, Weintraub D, et al. People with parkinson’s disease and normal MMSE score have a broad range of cognitive performance. Movement Disorders. 2014;29(10).
Mamikonyan E, Moberg PJ, Siderowf A, Duda JE, Have T Ten, Hurtig HI, et al. Mild cognitive impairment is common in Parkinson’s disease patients with normal Mini-Mental State Examination (MMSE) scores. Parkinsonism Relat Disord. 2009;15(3).
Bour A, Rasquin S, Boreas A, Limburg M, Verhey F. How predictive is the MMSE for cognitive performance after stroke? J Neurol. 2010;257(4).
Suda S, Muraga K, Ishiwata A, Nishimura T, Aoki J, Kanamaru T, et al. Early Cognitive Assessment Following Acute Stroke: Feasibility and Comparison between Mini-Mental State Examination and Montreal Cognitive Assessment. Journal of Stroke and Cerebrovascular Diseases. 2020;29(4).
Weaver NA, Kancheva AK, Lim JS, Biesbroek JM, Wajer IMH, Kang Y, et al. Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts. International Journal of Stroke. 2021 Oct 1;16(8):981–9.
Kosgallana A, Cordato D, Chan DKY, Yong J. Use of Cognitive Screening Tools to Detect Cognitive Impairment After an Ischaemic Stroke: a Systematic Review. SN Compr Clin Med. 2019;1(4).
Wu C, Dagg P, Molgat C. A pilot study to measure cognitive impairment in patients with severe schizophrenia with the Montreal Cognitive Assessment (MoCA). Schizophr Res. 2014;158(1–3).
Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–9.
Brown DS, Bernstein IH, McClintock SM, Munro Cullum C, Dewey RB, Husain M, et al. Use of the Montreal Cognitive Assessment and Alzheimer’s Disease-8 as cognitive screening measures in Parkinson’s disease. Int J Geriatr Psychiatry. 2016;31(3).
Dalrymple-Alford JC, MacAskill MR, Nakas CT, Livingston L, Graham C, Crucian GP, et al. The MoCA: Well-suited screen for cognitive impairment in Parkinson disease. Neurology. 2010;75(19).
Pendlebury ST, Cuthbertson FC, Welch SJV, Mehta Z, Rothwell PM. Underestimation of cognitive impairment by mini-mental state examination versus the montreal cognitive assessment in patients with transient ischemic attack and stroke: A population-based study. Stroke. 2010;41(6).
Nys GMS, Van Zandvoort MJE, De Kort PLM, Jansen BPW, Kappelle LJ, De Haan EHF. Restrictions of the Mini-Mental State Examination in acute stroke. Archives of Clinical Neuropsychology. 2005;20(5).
Freitas S, Simões MR, Alves L, Vicente M, Santana I. Montreal cognitive assessment (MoCA): Validation study for vascular dementia. Journal of the International Neuropsychological Society. 2012;18(6).
Hachinski V, Iadecola C, Petersen RC, Breteler MM, Nyenhuis DL, Black SE, et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006;37(9).
Belvederi Murri M, Folesani F, Costa S, Biancosino B, Colla C, Zerbinati L, et al. Screening for cognitive impairment in non-affective psychoses: A comparison between the SCIP and the MoCA. Schizophr Res. 2020;218.
Gil-Berrozpe GJ, Sánchez-Torres AM, García de Jalón E, Moreno-Izco L, Fañanás L, Peralta V, et al. Utility of the MoCA for cognitive impairment screening in long-term psychosis patients. Schizophr Res. 2020;216.
Yang Z, Abdul Rashid NA, Quek YF, Lam M, See YM, Maniam Y, et al. Montreal Cognitive Assessment as a screening instrument for cognitive impairments in schizophrenia. Schizophr Res. 2018;199.
Rosca EC, Albarqouni L, Simu M. Montreal Cognitive Assessment (MoCA) for HIV-Associated Neurocognitive Disorders. Vol. 29, Neuropsychology Review. 2019.
Woods SP, Moore DJ, Weber E, Grant I. Cognitive neuropsychology of HIV-associated neurocognitive disorders. Vol. 19, Neuropsychology Review. 2009.
Overton ET, Azad TD, Parker N, Demarco Shaw D, Frain J, Spitz T, et al. The Alzheimer’s disease-8 and Montreal Cognitive Assessment as screening tools for neurocognitive impairment in HIV-infected persons. J Neurovirol. 2013;19(1).
Bezdicek O, Majerova V, Novak M, Nikolai T, Ruzicka E, Roth J. Validity of the montreal cognitive assessment in the detection of cognitive dysfunction in Huntington’s disease. Appl Neuropsychol. 2013;20(1).
Ringkøbing SP, Larsen IU, Jørgensen K, Vinther-Jensen T, Vogel A. Cognitive Screening Tests in Huntington Gene Mutation Carriers: Examining the Validity of the Mini-Mental State Examination and the Montreal Cognitive Assessment. J Huntingtons Dis. 2020;9(1).
Ramirez-Garcia G, Galvez V, Diaz R, Campos-Romo A, Fernandez-Ruiz J. Montreal Cognitive Assessment (MoCA) performance in Huntington’s disease patients correlates with cortical and caudate atrophy. PeerJ. 2022;10.
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Copyright (c) 2024 Piotr Oleksy, Karol Zieliński, Bartosz Buczkowski, Dominik Sikora, Ewa Góralczyk, Adam Zając, Magdalena Mąka, Łukasz Papież, Jakub Kamiński
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