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. 2017;59(3):893-901.
doi: 10.3233/JAD-170203.

The Montreal Cognitive Assessment: Normative Data from a Large Swedish Population-Based Cohort

Emma Borland  1   2 , Katarina Nägga  1 , Peter M Nilsson  3 , Lennart Minthon  1 , Erik D Nilsson  1 , Sebastian Palmqvist  1   2
Affiliations

The Montreal Cognitive Assessment: Normative Data from a Large Swedish Population-Based Cohort

Emma Borland et al. J Alzheimers Dis. 2017.

Abstract

Background: The Montreal Cognitive Assessment (MoCA) has a high sensitivity for detecting cognitive dysfunction. Swedish normative data does not exist and international norms are often derived from populations where cognitive impairment has not been screened for and not been thoroughly assessed to exclude subjects with dementia or mild cognitive impairment.

Objective: To establish norms for MoCA and develop a regression-based norm calculator based on a large, well-examined cohort.

Methods: MoCA was administered on 860 randomly selected elderly people from a population-based cohort from the EPIC study. Cognitive dysfunction was screened for and further assessed at a memory clinic. After excluding cognitively impaired participants, normative data was derived from 758 people, aged 65-85.

Results: MoCA cut-offs (-1 to -2 standard deviations) for cognitive impairment ranged from <25 to <21 for the lowest educated and <26 to <24 for the highest educated, depending on age group. Significant predictors for MoCA score were age, sex and level of education.

Conclusion: We present detailed normative MoCA data and cut-offs according to the DSM-5 criteria for cognitive impairment based on a large population-based cohort of elderly individuals, screened and thoroughly investigated to rule out cognitive impairment. Level of education, sex, and age should be taken in account when evaluating MoCA score, which is facilitated by our online regression-based calculator that provide percentile and z-score for a subject's MoCA score.

Keywords: Cognitively healthy elderly; Montreal Cognitive Assessment; Swedish; excluding cognitively impaired; normative; population-based; representative.

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Figures

Fig.1
Fig.1
Flow chart of the enrollment process. 860 people completed MoCA together with MMSE and AQT. 133 participants scored <24 on MMSE, >90 on AQT or reported symptoms of cognitive impairment, and were summoned for a clinical investigation at the memory clinic. 31 of these 133 people were assessed as cognitively healthy and re-entered into the normative population and 102 were excluded according to the flowchart.
See this image and copyright information in PMC

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