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Updated: Jun 1, 2025

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
Published on: January 24, 2020
Cognitive testing and the hazards of cut-offs
1Consultant old age psychiatrist with Oxford Health NHS Foundation Trust and a member of the Law Faculty, University of Oxford, Oxford, UK. He has a particular interest in medical law, and the use of probability and statistics in legal cases. He regularly teaches law students as well as medical students and others. He is approved under section 12 of the Mental Health Act 1983 and is a member of the First-tier Tribunal (Mental Health) in England.
Abstract:
The article reviews some basic statistical concepts used in medicine, including the mean, standard deviation, sensitivity and specificity. Using this background the authors describe how these can be applied to cognitive tests, taking the Montreal Cognitive Assessment (MoCA) as an example. Two different approaches to using the MoCA in diagnosing dementia are considered: one using a fixed cut-off score, the other taking account of normative data about the effects of age and educational level on MoCA scores. It is recommended that clinicians assessing cognitive function should not rely on a fixed cut-off score, but where possible compare the patient's result with those of people of comparable age and educational background, although normative data of this kind are not always available.
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