Determining an appropriate cutting score for indication of impairment on the Montreal Cognitive Assessment

The Montreal Cognitive Assessment (MoCA) is a brief yet comprehensive cognitive instrument used to assess level of impairment in neurological populations. The purpose of the present study was to assess the ability of the MoCA to detect cognitive impairment in a veteran patient population referred for neuropsychological testing and to determine optimal cutoff scores on the MoCA when compared with widely used neuropsychological measures.

Using receiver operator characteristic (ROC) analyses, the findings indicate that the optimal cutoff score to detect impairment (i.e., ≤ 20) in the present sample was notably lower than that suggested by others.

Use of the previously suggested cut score of <26 may overpathologize neurologically intact individuals. Further research utilizing ROC curve analysis should be conducted to establish appropriate cutoff scores for various populations which may differ from the present sample.