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Clinical Manifestations.

Youssef A Ismail1, Huda A Auf1, Shahd A Sadik1

  • 1Faculty of Medicine Port Said Univeristy, Egypt, Port Said, Port Said, Egypt.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

The Montreal Cognitive Assessment (MoCA) effectively screens for dementia, demonstrating high sensitivity and specificity. It is particularly useful for ruling out dementia, with a high negative predictive value (NPV).

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychometrics

Background:

  • Dementia, classified as major neurocognitive disorder, involves significant cognitive impairment affecting daily life.
  • Mild neurocognitive disorder (MND) is diagnosed when cognitive impairment is moderate and does not yet severely impact daily activities.
  • The Montreal Cognitive Assessment (MoCA) is evaluated for its sensitivity and specificity as a screening tool for neurocognitive disorders.

Purpose of the Study:

  • To assess the diagnostic accuracy of the MoCA for identifying dementia and mild cognitive impairment (MCI).
  • To determine the suitability of MoCA as a screening tool in large-scale programs.
  • To establish optimal cutoff scores for MoCA in differentiating cognitive states.

Main Methods:

  • Analysis of data from 16,309 participants aged 55+ recruited from U.S. Alzheimer's Disease Research Centers (ADRCs).
  • Participants were categorized into three groups: no cognitive impairment (NoCI), mild cognitive impairment (MCI), and dementia, based on patient records and clinician-conducted cognitive assessments.
  • The National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS) was utilized, including complete diagnostic information and MoCA scores.

Main Results:

  • The MoCA demonstrated high accuracy in detecting dementia against NoCI, with a sensitivity of 83% and specificity of 82% at a cutoff score of 21.
  • For detecting MCI against NoCI, the MoCA showed a sensitivity of 77% and specificity of 69% at a cutoff score of 24.
  • The MoCA exhibited a high negative predictive value (NPV) across comparisons, indicating its strength in ruling out cognitive impairment, particularly dementia (NPV of 94%).

Conclusions:

  • The MoCA is confirmed as an effective screening tool for dementia, with strong sensitivity and specificity.
  • The MoCA's high NPV makes it a reliable instrument for excluding dementia in clinical settings.
  • The MoCA shows moderate ability in identifying MCI, suggesting its utility for broader cognitive screening.