Conversion between the Montreal Cognitive Assessment and the Mini-Mental Status Examination.
MMSE
MoCA
conversion
equating
equipercentile
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
revised:
20
09
2022
received:
15
06
2022
accepted:
14
10
2022
pubmed:
9
11
2022
medline:
22
3
2023
entrez:
8
11
2022
Statut:
ppublish
Résumé
Early and accurate detection of cognitive changes using simple tools is essential for an appropriate referral to a more detailed neurocognitive assessment and for the implementation of therapeutic strategies. The Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are two commonly used psychometric tests for cognitive screening. Both tests have different strengths and weaknesses. Preferences regarding test selection may therefore differ among clinicians. The aim of this retrospective observational cohort study was to define corresponding scores for the MMSE and the MoCA. We examined the relationship between the cognitive screening tests in 803 German-speaking Memory Clinic outpatients, encompassing a wide range of neurocognitive disorders. We produced a conversion table using the equipercentile equating method with log-linear smoothing. In addition, we conducted a systematic review of existing MMSE-MoCA conversions to create a table allowing for the conversion of MoCA scores into MMSE scores and vice versa using the weighted mean method. The Memory Clinic sample showed that the prediction of MMSE to MoCA was overall less accurate compared to the conversion from MoCA to MMSE. The 19 studies included after thorough literature search showed that MoCA scores were consistently lower than MMSE scores. Eleven of 19 conversion studies had addressed the conversion of the MoCA to the MMSE, while two studies converted MMSE to MoCA scores. Another six studies applied bi-directional conversions. We provide an easy-to-use table covering the entire range of scores and taking into account all currently existing conversion formulas. The comprehensive MMSE-MoCA conversion table enables a direct comparison of cognitive test scores at screening examinations and over the course of disease in patients with neurocognitive disorders.
Sections du résumé
BACKGROUND
Early and accurate detection of cognitive changes using simple tools is essential for an appropriate referral to a more detailed neurocognitive assessment and for the implementation of therapeutic strategies. The Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are two commonly used psychometric tests for cognitive screening. Both tests have different strengths and weaknesses. Preferences regarding test selection may therefore differ among clinicians. The aim of this retrospective observational cohort study was to define corresponding scores for the MMSE and the MoCA.
METHODS
We examined the relationship between the cognitive screening tests in 803 German-speaking Memory Clinic outpatients, encompassing a wide range of neurocognitive disorders. We produced a conversion table using the equipercentile equating method with log-linear smoothing. In addition, we conducted a systematic review of existing MMSE-MoCA conversions to create a table allowing for the conversion of MoCA scores into MMSE scores and vice versa using the weighted mean method.
RESULTS
The Memory Clinic sample showed that the prediction of MMSE to MoCA was overall less accurate compared to the conversion from MoCA to MMSE. The 19 studies included after thorough literature search showed that MoCA scores were consistently lower than MMSE scores. Eleven of 19 conversion studies had addressed the conversion of the MoCA to the MMSE, while two studies converted MMSE to MoCA scores. Another six studies applied bi-directional conversions. We provide an easy-to-use table covering the entire range of scores and taking into account all currently existing conversion formulas.
CONCLUSION
The comprehensive MMSE-MoCA conversion table enables a direct comparison of cognitive test scores at screening examinations and over the course of disease in patients with neurocognitive disorders.
Types de publication
Systematic Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
869-879Informations de copyright
© 2022 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.
Références
Prince M, Comas-Herrera A, Knapp M, Guerchet M, Karagiannidou M. World Alzheimer report 2016. Improving Healthcare for People Living with Dementia: Coverage, Quality and Costs Now and in the Future 2016. Available at: https://www.alz.co.uk/research/world-report-2016. Accessed October 27, 2021.
Yaffe K. Modifiable risk factors and prevention of dementia: what is the latest evidence? JAMA Intern Med. 2018;178(2):281-282. doi:10.1001/jamainternmed.2017.7299
Scheffels JF, Kräling H, Kalbe E, Kessler J. Konversionen von kognitiven screenings: mini-mental-status-test vs. Montreal cognitive assessment vs. DemTect [conversions of cognitive screenings: mini-mental state examination vs. Montreal cognitive assessment vs. DemTect]. Nervenarzt. 2018;89(12):1371-1377. doi:10.1007/s00115-018-0583-4
Ehrensperger M, Taylor K, Berres M, et al. BrainCheck - a very brief tool to detect incipient cognitive decline: optimized case-finding combining patient- and informant-based data. Alzheimers Res Ther. 2014;6(9):69. doi:10.1186/s13195-014-0069-y
Folstein MF, Folstein SE, McHugh PR. “mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198. doi:10.1016/0022-3956(75)90026-6
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699. doi:10.1111/j.1532-5415.2005.53221.x
Damian AM, Jacobson SA, Hentz JG, et al. The Montreal cognitive assessment and the mini-mental state examination as screening instruments for cognitive impairment: item analyses and threshold scores. Dement Geriatr Cogn Disord. 2011;31(2):126-131. doi:10.1159/000323867
Freitas S, Simões MR, Alves L, Santana I. Montreal cognitive assessment: validation study for mild cognitive impairment and Alzheimer disease. Alzheimer Dis Assoc Disord. 2013;27(1):37-43. doi:10.1097/WAD.0b013e3182420bfe
Larner AJ. Converting cognitive screening instrument test scores to MMSE scores: regression equations. Int J Geriatr Psychiatry. 2017;32:351-352. Doi. org/ 10. 1002/ gps. 4622.
American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
Hlávka JP, Kinoshita AT, Fang S, Hunt A. Clinical outcome measure crosswalks in Alzheimer's disease: a systematic review. J Alzheimers Dis. 2021;83(2):591-608. doi:10.3233/JAD-210060
Roalf DR, Moberg PJ, Xie SX, Wolk DA, Moelter ST, Arnold SE. Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging. Alzheimers Dement. 2013;9(5):529-537. doi:10.1016/j.jalz.2012.10.001
van Steenoven I, Aarsland D, Hurtig H, et al. Conversion between mini-mental state examination, Montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease. Mov Disord. 2014;29(14):1809-1815. doi:10.1002/mds.26062
Trzepacz PT, Hochstetler H, Wang S, Walker B, Saykin AJ. Alzheimer's disease neuroimaging I. relationship between the Montreal cognitive assessment and mini-mental state examination for assessment of mild cognitive impairment in older adults. BMC Geriatr. 2015;15:107. doi:10.1186/s12877-015-0103-3
Saczynski JS, Inouye SK, Guess J, et al. The Montreal cognitive assessment: creating a crosswalk with the mini-mental state examination. J Am Geriatr Soc. 2015;63(11):2370-2374. doi:10.1111/jgs.13710
Lawton M, Kasten M, May MT, et al. Validation of conversion between mini-mental state examination and Montreal cognitive assessment. Mov Disord. 2016;31(4):593-596. doi:10.1002/mds.26498
Bergeron D, Flynn K, Verret L, et al. Multicenter validation of an MMSE-MoCA conversion table. J Am Geriatr Soc. 2017;65(5):1067-1072. doi:10.1111/jgs.14779
Wong A, Black SE, Yiu SYP, et al. Converting MMSE to MoCA and MoCA 5-minute protocol in an educationally heterogeneous sample with stroke or transient ischemic attack. Int J Geriatr Psychiatry. 2018;33(5):729-734. doi:10.1002/gps.4846
Monsell SE, Dodge HH, Zhou XH, et al. Neuropsychology work group advisory to the clinical task force. Results from the NACC uniform data set neuropsychological battery crosswalk study. Alzheimer Dis Assoc Disord. 2016;30(2):134-139. doi:10.1097/WAD.0000000000000111
Kopecek M, Stepankova H, Lukavsky J, Ripova D, Nikolai T, Bezdicek O. Montreal cognitive assessment (MoCA): normative data for old and very old Czech adults. Appl Neuropsychol Adult. 2017;24(1):23-29. doi:10.1080/23279095.2015.1065261
Yang H, Yim D, Park MH. Converting from the Montreal cognitive assessment to the mini-mental state Examination-2. PLoS One. 2021;16(7):e0254055. doi:10.1371/journal.pone.0254055
Melikyan ZA, Malek-Ahmadi M, O'Connor K, Atri A, Kawas CH, Corrada MM. Norms and equivalences for MoCA-30, MoCA-22, and MMSE in the oldest-old. Aging Clin Exp Res. 2021;33:3303-3311. doi:10.1007/s40520-021-01886-z
Aiello EN, Pasotti F, Appollonio I, Bolognini N. Equating mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores: conversion norms from a healthy Italian population sample. Aging Clin Exp Res. 2022;34(7):1721-1724. doi:10.1007/s40520-022-02089-w
Roheger M, Xu H, Hoang MT, Eriksdotter M, Garcia-Ptacek S. Conversion between the mini-mental state examination and the Montreal cognitive assessment for patients with different forms of dementia. J Am Med Dir Assoc. 2022;S1525-8610(22):00288-2. doi:10.1016/j.jamda.2022.03.018
Kolen MJ, Brennan RL. Test Equating, Scaling, and Linking. Springer; 2004.
Helmi L, Meagher D, O'Mahony E, et al. Agreement and conversion formula between mini-mental state examination and Montreal cognitive assessment in an outpatient sample. World J Psychiatry. 2016;6(3):358-364. doi:10.5498/wjp.v6.i3.358
Solomon TM, de Bros GB, Budson AE, Mirkovic N, Murphy CA, Solomon PR. Correlational analysis of 5 commonly used measures of cognitive functioning and mental status: an update. Am J Alzheimers Dis Other Dement. 2014;29(8):718-722. doi:10.1177/1533317514534761
Yu RL, Lee WJ, Li JY, et al. Evaluating mild cognitive dysfunction in patients with Parkinson's disease in clinical practice in Taiwan. Sci Rep. 2020;10(1):1014. doi:10.1038/s41598-020-58042-2
Olin JT, Zelinski EM. The 12-month reliability of the mini-mental state examination. Psychol Assess. 1991;3(3):427-432. doi:10.1037/1040-3590.3.3.427
Monsch AU, Kressig RW. Specific care program for the older adults: memory clinics. Eur Geriatric Med. 2010;1(2):128-131. doi:10.1016/j.eurger.2010.03.006
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent Evidence and Development of a Shorter Version. Clinical Gerontology: A Guide to Assessment and Intervention 165-173. The Haworth Press; 1986.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571. doi:10.1001/archpsyc.1961.01710120031004
Beck IR, Schmid NS, Berres M, Monsch AU. Establishing robust cognitive dimensions for characterization and differentiation of patients with Alzheimer's disease, mild cognitive impairment, frontotemporal dementia and depression. Int J Geriatr Psychiatry. 2014;29(6):624-634. doi:10.1002/gps.4045
Albano AD. Equate: an R package for observed-score linking and equating. J Stat Softw. 2016;74(8):1-36. doi:10.18637/jss.v074.i08WOS:000392514200001
Mooney CZ, Duval RD. Bootstrapping: A Nonparametric Approach to Statistical Inference. Sage Publications; 1993.
Chen X, Wen H, Wang J, Yi Y, Wu J, Liao X. Conversion between mini-mental state examination and Montreal cognitive assessment scores in older adults undergoing selective surgery using Rasch analysis. J Adv Nurs. 2021;77(2):729-741. doi:10.1111/jan.14638
Jung YI, Jeong EH, Lee H, et al. Validation of MoCA-MMSE conversion scales in Korean patients with cognitive impairments. Dement Neurocogn Disord. 2018;17(4):148-155. doi:10.12779/dnd.2018.17.4.148