P-3: Is There An Optimal Cut-Off MoCA Score That Can Be Used As An Indicator of Dementia? A Scoping Review
Jennifer Lee, Andrea Chen, Jason Locklin*, Linda Lee, Tejal Patel
OBJECTIVES: Cognitive decline sufficient enough to interfere with independent functioning is required to diagnose dementia; however ascertaining functional impairment from patient history can sometimes be challenging. A threshold score on the Montreal Cognitive Assessment (MoCA), below which functional impairment is typically associated, could help clinicians better triage those with cognitive impairment who require more resource intensive in-depth assessment of functional impairment. The aim of this scoping review was to determine the empirical support for using a particular score on the MoCA as an indicator of dementia.
METHODS: The databases Embase, CINAHL, Medline, Pubmed, and PsycINFO were searched using the search strategy (MoCA OR Montreal-Cognitive-Assessment) AND (dementia) AND (diagnos*) as well as associated reference lists. Studies were included if they presented results from English-language MoCA screening of patients with a diagnosis of dementia or diagnostic criteria, and excluded if they examined impairment due to other conditions.
RESULTS: We identified 20 relevant studies that met the inclusion criteria. Of these, 17 presented optimal cut-off scores for dementia, ranging from 17 to 26, with a median score of 20.5 (mode=17 SD=4.8). Participants were recruited from specialist clinic settings (both for subjective cognitive impairment and unrelated geriatric issues), and population-derived samples.
DISCUSSION: Researchers have examined optimal cut-off MoCA scores as a screen for dementia, yet these scores and the methodology vary widely. Further, no data are currently available from primary care settings.
CONCLUSION: The research suggests a basis for applying the MoCA in this way, but there is a need for further research.