Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-13T10:55:11.230Z Has data issue: false hasContentIssue false

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?

Published online by Cambridge University Press:  14 November 2018

Tiago C. C. Pinto*
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Leonardo Machado
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Tatiana M. Bulgacov
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Antônio L. Rodrigues-Júnior
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Maria L. G. Costa
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Rosana C. C. Ximenes
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
Everton B. Sougey
Affiliation:
Post-graduate program in Neuropsychiatry and Behavioral Science at the Federal University of Pernambuco, Recife, Brazil
*
Correspondence should be addressed to: Tiago Coimbra Costa Pinto, Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Avenida da Engenharia, S/N, Prédio dos Programas de Pós-Graduação do CCS-UFPE, Cidade Universitária, Recife-PE 50740-600, Brazil. Phone: +55 87 988727241; Fax: +55 81 21268539. Email: tcoimbra.pinto@gmail.com.

Abstract

Objective:

To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).

Method:

A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).

Result:

More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p < 0.001].

Conclusion:

The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.

Type
Review Article
Copyright
© International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, M. S. et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on aging-Alzheimer’s association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7, 270279. doi: 10.1016/j.jalz.2011.03.008.CrossRefGoogle Scholar
Alzheimer’s Association. (2011). 2011 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 7, 208244. doi: 10.1016/j.jalz.2011.02.004.CrossRefGoogle Scholar
Banerjee, S. (2010). Living well with dementia–development of the national dementia strategy for England. International Journal of Geriatric Psychiatry, 25, 917922. doi: 10.1002/gps.2598.CrossRefGoogle ScholarPubMed
Batty, G. D. et al. (2013). Oral disease in relation to future risk of dementia and cognitive decline: prospective cohort study based on the action in diabetes and vascular disease: preterax and diamicron modified-release controlled evaluation (ADVANCE) trial. European Psychiatry, 28, 4952. doi: 10.1016/j.eurpsy.2011.07.005.CrossRefGoogle ScholarPubMed
Boise, L., Morgan, D. L., Kaye, J. and Camicioli, R. (1999). Delays in the diagnosis of dementia: perspectives of family caregivers. American Journal of Alzheimer's Disease & Other Dementias, 14, 2026. doi: 10.1177/153331759901400101.CrossRefGoogle Scholar
Bos, D. et al. (2015). Atherosclerotic calcification is related to a higher risk of dementia and cognitive decline. Alzheimer's & Dementia, 11, 639647.e1. doi: 10.1016/j.jalz.2014.05.1758.CrossRefGoogle ScholarPubMed
Bruscoli, M. and Lovestone, S. (2004). Is MCI really just early dementia? A systematic review of conversion studies. International Psychogeriatrics 16, 129140. doi: 10.1017/S1041610204000092.CrossRefGoogle ScholarPubMed
Carnero-Pardo, C. (2014). Should the mini-mental state examination be retired. Neurologia, 29, 473481. doi: 10.1016/j.nrl.2013.07.003.CrossRefGoogle ScholarPubMed
Carnero-Pardo, C. (2015). Reasons for retiring the mini-mental state examination. Neurologia, 30, 588589. doi: 10.1016/j.nrl.2014.04.002.CrossRefGoogle ScholarPubMed
Cecato, J. F., Montiel, J. M., Bartholomeu, D. and Martinelli, J. E. (2014). Poder preditivo do MoCa na avaliação neuropsicológica de pacientes com diagnóstico de demência. Revista Brasileira de Geriatria e Gerontologia, 17, 707719. doi: 10.1590/1809-9823.2014.13123.CrossRefGoogle Scholar
Chen, K. L. et al. (2016). Validation of the Chinese version of Montreal Cognitive Assessment basic for screening mild cognitive impairment. Journal of the American Geriatrics Society, 64, e285e290. doi: 10.1111/jgs.14530.CrossRefGoogle ScholarPubMed
Chu, L. W., Ng, K. H., Law, A. C., Lee, A. M. and Kwan, F. (2015). Validity of the cantonese Chinese Montreal Cognitive Assessment in southern Chinese. Geriatrics & Gerontology International, 15, 96103. doi: 10.1111/ggi.12237.CrossRefGoogle ScholarPubMed
Davis, D. H. et al. (2013). Neuropsychological tests for the diagnosis of Alzheimer’s disease dementia and other dementias: a generic protocol for cross-sectional and delayed-verification studies. The Cochrane Database of Systematic Reviews, 3, CD010460. doi: 10.1002/14651858.CD010460.Google Scholar
De Vugt, M. E. and Verhey, F. R. (2013). The impact of early dementia diagnosis and intervention on informal caregivers. Progress in Neurobiology, 110, 5462. doi: 10.1016/j.pneurobio.2013.04.005.CrossRefGoogle ScholarPubMed
Delgado, C., Araneda, A. and Behrens, M. I. (2017). Validación del instrumento Montreal Cognitive Assessment en español en adultos mayores de 60 años. Neurología. doi: 10.1016/j.nrl.2017.01.013 (Epub ahead of print).CrossRefGoogle Scholar
Dong, Y. et al. (2012). The Montreal Cognitive Assessment is superior to the mini-mental state examination in detecting patients at higher risk of dementia. International Psychogeriatrics, 24, 17491755. doi: 10.1017/S1041610212001068.CrossRefGoogle Scholar
Dong, Y. et al. (2013). Comparison of the Montreal Cognitive Assessment and the mini-mental state examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study. International Psychogeriatrics, 25, 18311838. doi: 10.1017/S1041610213001129.CrossRefGoogle Scholar
Dubois, B., Padovani, A., Scheltens, P., Rossi, A. and Dell’Agnello, G. (2015). Timely diagnosis for Alzheimer’s disease: a literature review on benefits and challenges. Journal of Alzheimer’s Disease, 49, 617631. doi: 10.3233/JAD-150692.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. doi: 10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Forlenza, O. V. et al. (2010). Clinical and biological predictors of Alzheimer’s disease in patients with amnestic mild cognitive impairment. Revista Brasileira de Psiquiatria, 32, 216222. doi: 10.1590/S1516-44462010005000002.CrossRefGoogle ScholarPubMed
Freitas, S., Simões, M. R., Alves, L. and Santana, I. (2013). Montreal Cognitive Assessment: validation study for mild cognitive impairment and Alzheimer disease. Alzheimer Disease and Associated Disorders, 27, 3743. doi: 10.1097/WAD.0b013e3182420bfe.CrossRefGoogle ScholarPubMed
Fujiwara, Y. et al. (2010). Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment. Geriatrics & Gerontology International, 10, 225232. doi: 10.1111/j.1447-0594.2010.00585.x.CrossRefGoogle ScholarPubMed
Gil, L., Ruiz de Sánchez, C., Gil, F., Romero, S. J. and Pretelt Burgos, F. (2015). Validation of the Montreal Cognitive Assessment (MoCA) in Spanish as a screening tool for mild cognitive impairment and mild dementia in patients over 65 years old in Bogotá, Colombia. International Journal of Geriatric Psychiatry, 30, 655662. doi: 10.1002/gps.4199.CrossRefGoogle ScholarPubMed
Guo, Q. H., Cao, X. Y., Zhou, Y., Zhao, Q. H., Ding, D. and Hong, Z. (2010). Application study of quick cognitive screening test in identifying mild cognitive impairment. Neuroscience Bulletin, 26, 4754. doi: 10.1007/s12264-010-0816-4.CrossRefGoogle ScholarPubMed
Hanzevacki, M., Ozegovic, G., Simovic, I. and Bajic, Z. (2011). Proactive approach in detecting elderly subjects with cognitive decline in general practitioners’ practices. Dementia and Geriatric Cognitive Disorders EXTRA, 1, 93102. doi: 10.1159/000327076.CrossRefGoogle ScholarPubMed
Hebert, L. E., Weuve, J., Scherr, P. A. and Evans, D. A. (2013). Alzheimer disease in the United States (2010-2050) estimated using the 2010 census. Neurology, 80, 17781783. doi: 10.1212/WNL.0b013e31828726f5.CrossRefGoogle ScholarPubMed
Horton, D. K., Hynan, L. S., Lacritz, L. H., Rossetti, H. C., Weiner, M. F. and Cullum, C. M. (2015). An abbreviated Montreal Cognitive Assessment (MoCA) for dementia screening. The Clinical Neuropsychologist, 29, 413425. doi: 10.1080/13854046.2015.1043349.CrossRefGoogle ScholarPubMed
Hsu, J. L. et al. (2015). Improved predictive ability of the Montreal Cognitive Assessment for diagnosing dementia in a community-based study. Alzheimer’s Research & Therapy, 7, 69. doi: 10.1186/s13195-015-0156-8.CrossRefGoogle Scholar
Hu, J. B. et al. (2013). Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in eastern China: preliminary findings. Archives of Gerontology and Geriatrics, 56, 3843. doi: 10.1016/j.archger.2012.05.008.CrossRefGoogle ScholarPubMed
Hurd, M. D., Martorell, P., Delavande, A., Mullen, K. J. and Langa, K. M. (2013). Monetary costs of dementia in the United States. The New England Journal of Medicine, 368, 13261334. doi: 10.1056/NEJMsa1204629.CrossRefGoogle ScholarPubMed
Ihl, R., Frölich, L., Dierks, T., Martin, E. M. and Maurer, K. (1992). Differential validity of psychometric tests in dementia of Alzheimer type. Psychiatry Research, 44, 93106. doi: 10.1016/0165-1781(92)90044-4.CrossRefGoogle Scholar
Janelidze, M. et al. (2017). Validity of the Georgian Montreal Cognitive Assessment for the screening of mild cognitive impairment and dementia. American Journal of Alzheimer’s Disease & Other Dementias, 32, 3640. doi: 10.1177/1533317516679304.CrossRefGoogle ScholarPubMed
Kasai, M., Meguro, K., Nakamura, K., Nakatsuka, M., Ouchi, Y. and Tanaka, N. (2012). Screening for very mild subcortical vascular dementia patients aged 75 and above using the Montreal Cognitive Assessment and mini-mental state examination in a community: the Kurihara project. Dementia and Geriatric Cognitive Disorders Extra, 2, 503515. doi: 10.1159/000340047.CrossRefGoogle Scholar
Kaya, Y., Aki, O. E., Can, U. A., Derle, E., Kibaroğlu, S. and Barak, A. (2014). Validation of Montreal Cognitive Assessment and discriminant power of Montreal Cognitive Assessment subtests in patients with mild cognitive impairment and Alzheimer dementia in Turkish population. Journal of Geriatric Psychiatry and Neurology, 27, 103109. doi: 10.1177/0891988714522701.CrossRefGoogle ScholarPubMed
Lee, J. Y. et al. (2008). Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal Cognitive Assessment. Journal of Geriatric Psychiatry and Neurology, 21, 104110. doi: 10.1177/0891988708316855.CrossRefGoogle ScholarPubMed
Liberati, A. et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine, 6, e1000100. doi: 10.1371/journal.pmed.1000100.CrossRefGoogle ScholarPubMed
Lifshitz, M., Dwolatzky, T. and Press, Y. (2012). Validation of the Hebrew version of the MoCA test as a screening instrument for the early detection of mild cognitive impairment in elderly individuals. Journal of Geriatric Psychiatry and Neurology, 25, 155161. doi: 10.1177/0891988712457047.CrossRefGoogle ScholarPubMed
Lu, J. et al. (2011). Montreal Cognitive Assessment in detecting cognitive impairment in Chinese elderly individuals: a population-based study. Journal of Geriatric Psychiatry and Neurology, 24, 184190. doi: 10.1177/0891988711422528.CrossRefGoogle ScholarPubMed
Luis, C. A., Keegan, A. P. and Mullan, M. (2009). Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US. International Journal of Geriatric Psychiatry, 24, 197201. doi: 10.1002/gps.2101.CrossRefGoogle ScholarPubMed
Magierska, J., Magierski, R., Fendler, W., Kłoszewska, I. and Sobów, T. M. (2012). Clinical application of the Polish adaptation of the Montreal Cognitive Assessment (MoCA) test in screening for cognitive impairment. Neurologia I Neurochirurgia Polska, 46, 130139. doi: 10.5114/ninp.2012.28255.CrossRefGoogle ScholarPubMed
Malek-Ahmadi, M., Davis, K., Belden, C. M. and Sabbagh, M. N. (2014). Comparative analysis of the Alzheimer’s questionnaire (AQ) with the CDR sum of Boxes, MoCA, and MMSE. Alzheimer Disease and Associated Disorders, 28, 296298. doi: 10.1097/WAD.0b013e3182769731.CrossRefGoogle ScholarPubMed
Matías-Guiu, J. A., Valles-Salgado, M., Rognoni, T., Hamre-Gil, F., Moreno-Ramos, T. and Matías-Guiu, J. (2017). Comparative diagnostic accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for screening of Alzheimer disease. Dementia and Geriatric Cognitive Disorders, 43, 237246. doi: 10.1159/000469658.CrossRefGoogle ScholarPubMed
Matsumoto, A. et al. (2014). Day-to-day variability in home blood pressure is associated with cognitive decline: the Ohasama study. Hypertension, 63, 13331338. doi: 10.1161/HYPERTENSIONAHA.113.01819.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease report of the NINCDS-ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology, 34, 939939. doi: 10.1212/WNL.34.7.939.CrossRefGoogle ScholarPubMed
Mellor, D. et al. (2016). Determining appropriate screening tools and cut-points for cognitive impairment in an elderly Chinese sample. Psychological Assessment, 28, 13451353. doi: 10.1037/pas0000271.CrossRefGoogle Scholar
Memória, C. M., Yassuda, M. S., Nakano, E. Y. and Forlenza, O. V. (2013). Brief screening for mild cognitive impairment: validation of the Brazilian version of the Montreal Cognitive Assessment. International Journal of Geriatric Psychiatry, 28, 3440. doi: 10.1002/gps.3787.CrossRefGoogle ScholarPubMed
Nasreddine, Z. S. et al. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695699. doi: 10.1111/j.1532-5415.2005.53221.x.CrossRefGoogle ScholarPubMed
Olazarán, J. et al. (2016). Practical application of brief cognitive tests. Neurología, 31, 183194. doi: 10.1016/j.nrl.2015.07.009.CrossRefGoogle ScholarPubMed
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303308. doi: 10.1001/archneur.56.3.303.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194. doi: 10.1111/j.1365-2796.2004.01388.x.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2011). Clinical practice. Mild cognitive impairment. The New England Journal of Medicine, 364, 22272234. doi: 10.1056/NEJMcp0910237.CrossRefGoogle ScholarPubMed
Portet, F. et al. (2006). Mild cognitive impairment (MCI) working group of the European consortium on Alzheimer’s disease (EADC). Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI working group of the European consortium on Alzheimer’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 77, 714718. doi: 10.1136/jnnp.2005.085332.CrossRefGoogle Scholar
Prince, M., Bryce, R. and Ferri, C. (2011). World Alzheimer report 2011: the benefits of early diagnosis and intervention. Alzheimer Disease International, http://www.alz.co.uk/research/WorldAlzheimerReport2011.pdf.Google Scholar
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia, 9, 6375.e2. doi: 10.1016/j.jalz.2012.11.007.CrossRefGoogle ScholarPubMed
Quiroga, P., Albala, C. and Klaasen, G. (2004). Validación de un test de tamizaje para el diagnóstico de demencia asociada a edad, en Chile. Revista Medica de Chile, 132, 467478. doi: 10.4067/s0034-98872004000400009.Google Scholar
Roalf, D. R., Moberg, P. J., Xie, S. X., Wolk, D. A., Moelter, S. T. and Arnold, S. E. (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer’s disease, mild cognitive impairment, and healthy aging. Alzheimer's & Dementia, 9, 529537. doi: 10.1016/j.jalz.2012.10.001.CrossRefGoogle ScholarPubMed
Roalf, D. R. et al. (2017). Bridging cognitive screening tests in neurologic disorders: a crosswalk between the short Montreal Cognitive Assessment and mini-mental state examination. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 13, 947952. doi: 10.1016/j.jalz.2017.01.015.CrossRefGoogle ScholarPubMed
Saleh, A. A. et al. (2018). Validation of Montreal Cognitive Assessment-basic in a sample of elderly Egyptians with neurocognitive disorders. Aging & Mental Health, 9, 17. doi: 10.1080/13607863.2018.1428936.CrossRefGoogle Scholar
Schönknecht, P., Pantel, J., Kruse, A. and Schröder, J. (2005). Prevalence and natural course of aging-associated cognitive decline in a population-based sample of young-old subjects. American Journal of Psychiatry, 162, 20712077. doi: 10.1176/appi.ajp.162.11.2071.CrossRefGoogle Scholar
Tan, J. P. et al. (2015). Optimal cutoff scores for dementia and mild cognitive impairment of the Montreal Cognitive Assessment among elderly and oldest-old Chinese population. Journal of Alzheimer’s Disease, 43, 14031412. doi: 10.3233/JAD-141278.CrossRefGoogle ScholarPubMed
Tombaugh, T. N. and McIntyre, N. J. (1992). The mini-mental state examination: a comprehensive review. Journal of the American Geriatrics Society, 40, 922935. doi: 10.1111/j.1532-5415.1992.tb01992.x.CrossRefGoogle ScholarPubMed
Tsai, C. F., Lee, W. J., Wang, S. J., Shia, B. C., Nasreddine, Z. and Fuh, J. L. (2012). Psychometrics of the Montreal Cognitive Assessment (MoCA) and its subscales: validation of the Taiwanese version of the MoCA and an item response theory analysis. International Psychogeriatrics, 24, 651658. doi: 10.1017/S1041610211002298.CrossRefGoogle ScholarPubMed
Tsai, J. C. et al. (2016). Comparing the sensitivity, specificity, and predictive values of the Montreal Cognitive Assessment and mini-mental state examination when screening people for mild cognitive impairment and dementia in Chinese population. Archives of Psychiatric Nursing, 30, 486491. doi: 10.1016/j.apnu.2016.01.015.CrossRefGoogle ScholarPubMed
Tsoi, K. K., Chan, J. Y., Hirai, H. W., Wong, S. Y. and Kwok, T. C. (2015). Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Internal Medicine, 175, 14501458. doi: 10.1001/jamainternmed.2015.2152.CrossRefGoogle ScholarPubMed
Velayudhan, L. et al. (2014). Review of brief cognitive tests for patients with suspected dementia. International Psychogeriatrics, 26, 12471262. doi: 10.1017/S1041610214000416.CrossRefGoogle ScholarPubMed
Wang, C. S. M., Pai, M. C., Chen, P. L., Hou, N. T., Chien, P. F. and Huang, Y. C. (2013). Montreal Cognitive Assessment and mini-mental state examination performance in patients with mild-to-moderate dementia with Lewy bodies, Alzheimer’s disease, and normal participants in Taiwan. International Psychogeriatrics, 25, 18391848. doi: 10.1017/S1041610213001245.CrossRefGoogle ScholarPubMed
Whiting, P. F. et al. (2011). QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine, 155, 529536. doi: 10.7326/0003-4819-155-8-201110180-00009.CrossRefGoogle ScholarPubMed
Wimo, A., Jönsson, L., Bond, J., Prince, M. and Winblad, B. (2013a). Alzheimer disease international the worldwide economic impact of dementia 2010. Alzheimer's & Dementia, 9, 111.CrossRefGoogle ScholarPubMed
Wimo, A. et al. (2013b). The GERAS study: a prospective observational study of costs and resource use in community dwellers with Alzheimer’s disease in three European countries–study design and baseline findings. Journal of Alzheimer's Disease, 36, 385399. doi: 10.3233/JAD-122392.CrossRefGoogle ScholarPubMed
Wind, A. W., Schellevis, F. G., Van Staveren, G. E. R. R. I. T., Scholten, R. J., Jonker, C. and Van Eijk, J. T. M. (1997). Limitations of the mini-mental state examination in diagnosing dementia in general practice. International Journal of Geriatric Psychiatry, 12, 101108. doi: 10.1002/(SICI)1099-1166(199701)12:1<101::AID-GPS469>3.0.CO;2-R.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Yeung, P. Y., Wong, L. L., Chan, C. C., Leung, J. L. and Yung, C. Y. (2014). A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Medical Journal, 20, 504510.Google Scholar
Yu, J., Li, J. and Huang, X. (2012). The Beijing version of the Montreal Cognitive Assessment as a brief screening tool for mild cognitive impairment: a community-based study. BMC Psychiatry, 12, 156. doi: 10.1186/1471-244X-12-156.CrossRefGoogle ScholarPubMed
Zeki Al Hazzouri, A. et al. (2014). Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69, 595601. doi: 10.1093/gerona/glt139.CrossRefGoogle ScholarPubMed
Zhou, S. A. et al. (2014). The influence of education on Chinese version of Montreal Cognitive Assessment in detecting amnesic mild cognitive impairment among older people in a Beijing rural community. The Scientific World Journal. 2014, 689456. doi: 10.1155/2014/689456.CrossRefGoogle Scholar
Zhu, C. W. et al. (2015). Health-care use and cost in dementia caregivers: longitudinal results from the predictors caregiver study. Alzheimer’s & Dementia, 11, 444454. doi: 10.1016/j.jalz.2013.12.018.CrossRefGoogle Scholar
Supplementary material: File

Pinto et al. supplementary material

Table S1

Download Pinto et al. supplementary material(File)
File 20.1 KB