JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (12): 1662-1667.doi: 10.3969/j.issn.1674-8115.2021.12.017

• Clinical research • Previous Articles    

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

An-qi XIA1,2(), Jun LI3(), Ling YUE1,2, Bo HONG1,2, Feng YAN1,2, Ning SU1,2, Shi-fu XIAO1,2, Yuan-yuan LIU1,2(), Tao WANG1,2()   

  1. 1.Department of Geriatric Psychiatry, Shanghai Mental health center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    2.Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai 200030, China
    3.Chaohu Hospital of Anhui Medical University, Hefei 238000, China
  • Received:2021-07-29 Online:2021-12-28 Published:2022-01-28
  • Contact: Yuan-yuan LIU,Tao WANG;;
  • Supported by:
    China Ministry of Science and Technology Grants(2009BAI77B03);Shanghai Health System Excellent Talent Training Program (Excellent Subject Leader)(2017BR054);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20172029);Collaborative Innovation Center for Translational Medicine of Shanghai Jiao Tong University School of Medicine Project(TM201728)

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.


·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.


·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.


·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

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