Application of Montreal Cognitive Assessment Scale to the elderly in Chinese community

doi:10.3969/j.issn.1674-8115.2021.12.017

Abstract

Abstract: Objective

·To update the cut-off value of the normal elderly (NE) and mild cognitive impairment (MCI) elderly in urban areas of China according to the Montreal Cognitive Assessment (MoCA) scores and analyze the sections of MoCA.

Methods

·A cross-sectional study was conducted to investigate the elderly over 60 years old in ten cities of China. Mini-Mental State Examination (MMSE) and MoCA (Beijing version) were used to assess cognitive function. Data was statistically analyzed by SPSS 19.0.

Results

·There were 2 367 NE, 553 MCI patients, 1 319 males and 1 601 females, with an average age of (70.6±7.5) years and an average length of education of (8.7±5.2) years. There were significant difference in age and length of education between MCI and NE groups (t=12.3, P=0.000; t=-13.5, P=0.000). Female was more likely to have MCI (χ²＝13.5, P=0.000). By analyzing the score of MoCA of the NE, it was found that the MoCA score of males, high education level and low age group were higher. Rhinoceros and camel in naming, church and face in delayed memory, alternating connection test and pointer position in clock drawing were more difficult. The sections' scores of MoCA showed that the subjects performed better in the orientation and attention tests, while the scores of visuospatial functions, delayed recalling, sentence repetition and abstract ability were lower. The best cut-off value of MoCA was 20 (sensitivity = 63.7%, specificity = 75.7%). The area under the curve was 0.76.

Conclusion

·MoCA (Beijing version) has a good distinction between NE and MCI, and 20 can be used as a cut-off value in MCI subjects screening in urban areas of China. MoCA score is influenced by age, gender and education level. Based on difficulty analysis, some words that evaluate memory could be replaced (replacing “face” with “hand” and replacing “church” with “factory”).

Key words: Montreal Cognitive Assessment Scale (MoCA), difficulty assessment, mild cognitive impairment, cut-off value

CLC Number:

R749.1+6

An-qi XIA, Jun LI, Ling YUE, Bo HONG, Feng YAN, Ning SU, Shi-fu XIAO, Yuan-yuan LIU, Tao WANG. Application of Montreal Cognitive Assessment Scale to the elderly in Chinese community[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1662-1667.

Figures/Tables 6

TrendMD

References 27

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Characteristic	MCI （n=553）	NE （n=2 367）	P value
Gender/n（%）			0.000
Male	205 （37.1）	1 114 （47.1）
Female	348 （62.9）	1 253 （52.9）
Age/year
60-64	62.2±1.5	62.0±1.4	0.235
65-69	67.0±1.6	66.9±1.4	0.473
70-74	72.2±1.4	71.9±1.4	0.063
75-79	77.1±1.4	76.8±1.4	0.051
80-84	81.8±1.3	81.7±1.4	0.544
≥85	88.4±3.1	87.8±2.6	0.318
Length of education/year
>12	14.1±2.3	14.4±2.2	0.283
7-12	7.8±1.5	8.2±1.4	0.000
1-6	3.1±1.3	3.3±1.3	0.265
0	0.0±0.0	0.0±0.0	-

Characteristic	MCI （n=553）	NE （n=2 367）	P value
Gender/n（%）			0.000
Male	205 （37.1）	1 114 （47.1）
Female	348 （62.9）	1 253 （52.9）
Age/year
60-64	62.2±1.5	62.0±1.4	0.235
65-69	67.0±1.6	66.9±1.4	0.473
70-74	72.2±1.4	71.9±1.4	0.063
75-79	77.1±1.4	76.8±1.4	0.051
80-84	81.8±1.3	81.7±1.4	0.544
≥85	88.4±3.1	87.8±2.6	0.318
Length of education/year
>12	14.1±2.3	14.4±2.2	0.283
7-12	7.8±1.5	8.2±1.4	0.000
1-6	3.1±1.3	3.3±1.3	0.265
0	0.0±0.0	0.0±0.0	-

Group	Length of education/year
Group	>12	7-12	1-6	0	Total
Male
60-64 year	25.5±2.9	24.4±3.5	21.4±3.4	21.0±5.6	24.6±3.5
65-69 year	25.2±4.1	24.0±3.5	20.8±5.4	18.8±5.9	24.3±4.2
70-74 year	24.8±3.1	23.0±3.9	20.4±3.9	14.8±3.4	23.6±3.9
75-79 year	24.4±3.3	22.0±4.9	19.5±4.1	17.5±4.4	22.4±4.6
80-84 year	23.1±3.5	21.8±4.5	17.5±4.3	14.3±3.7	20.2±5.0
≥85 year	19.4±4.7	20.7±5.0	17.7±4.2	18.3±3.6	19.2±4.5
Female
60-64 year	25.7±3.1	24.2±3.8	20.4±3.8	17.7±5.9	24.1±4.1
65-69 year	25.7±3.5	23.0±4.0	18.5±4.3	16.0±5.0	23.1±4.8
70-74 year	24.4±4.2	22.0±4.6	19.8±4.3	14.7±5.5	22.1±5.3
75-79 year	24.2±3.5	20.4±4.4	17.2±5.1	14.7±4.5	19.1±5.7
80-84 year	21.7±4.7	21.6±4.2	16.4±5.5	13.3±5.2	17.1±6.2
≥85 year	23.7±7.1	17.8±5.1	19.9±6.8	11.5±6.6	15.3±7.7

Group	Length of education/year
Group	>12	7-12	1-6	0	Total
Male
60-64 year	25.5±2.9	24.4±3.5	21.4±3.4	21.0±5.6	24.6±3.5
65-69 year	25.2±4.1	24.0±3.5	20.8±5.4	18.8±5.9	24.3±4.2
70-74 year	24.8±3.1	23.0±3.9	20.4±3.9	14.8±3.4	23.6±3.9
75-79 year	24.4±3.3	22.0±4.9	19.5±4.1	17.5±4.4	22.4±4.6
80-84 year	23.1±3.5	21.8±4.5	17.5±4.3	14.3±3.7	20.2±5.0
≥85 year	19.4±4.7	20.7±5.0	17.7±4.2	18.3±3.6	19.2±4.5
Female
60-64 year	25.7±3.1	24.2±3.8	20.4±3.8	17.7±5.9	24.1±4.1
65-69 year	25.7±3.5	23.0±4.0	18.5±4.3	16.0±5.0	23.1±4.8
70-74 year	24.4±4.2	22.0±4.6	19.8±4.3	14.7±5.5	22.1±5.3
75-79 year	24.2±3.5	20.4±4.4	17.2±5.1	14.7±4.5	19.1±5.7
80-84 year	21.7±4.7	21.6±4.2	16.4±5.5	13.3±5.2	17.1±6.2
≥85 year	23.7±7.1	17.8±5.1	19.9±6.8	11.5±6.6	15.3±7.7

Factor	Unstandardized β	Standardized β	t value
Age	-0.265	-0.311	-23.196
Year of education	0.631	0.510	37.1
Gender	-0.977	-0.074	-5.61