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Meta-Analysis
. 2023 Jul;19(7):3235-3243.
doi: 10.1002/alz.13040. Epub 2023 Mar 19.

Accuracy of the Montreal Cognitive Assessment tool for detecting mild cognitive impairment: A systematic review and meta-analysis

Nayaar Islam  1 , Rola Hashem  1 , Maryse Gad  1 , Aime Brown  1 , Brooke Levis  2   3 , Christel Renoux  3 , Brett D Thombs  3 , Matthew Df McInnes  1   4   5
Affiliations
Meta-Analysis

Accuracy of the Montreal Cognitive Assessment tool for detecting mild cognitive impairment: A systematic review and meta-analysis

Nayaar Islam et al. Alzheimers Dement. 2023 Jul.

Abstract

Introduction: This systematic review evaluates the accuracy of the Montreal Cognitive Assessment (MoCA) for detecting mild cognitive impairment (MCI).

Methods: We searched MEDLINE, PSYCInfo, EMBASE, and Cochrane CENTRAL (1995-2021) for studies comparing the MoCA with validated diagnostic criteria to identify MCI in general practice. Screening, data extraction, and risk of bias assessment were performed independently, in duplicate. Pooled sensitivity and specificity for MoCA cutoffs were estimated using bivariate meta-analysis.

Results: Thirteen studies [2158 participants, 948(44%) with MCI] were included; 10 used Petersen criteria as the reference standard. Risk of bias of studies were high or unclear for all domains except reference standard. Sensitivity and specificity were 73.5%(95% confidence interval: 56.7-85.5) and 91.3%(84.6-95.3) at cutoff <23; 79.5%(67.1-88.0) and 83.7%(75.4-89.6) at cutoff <24; and 83.8%(75.6-89.6) and 70.8(62.1-78.3) at cutoff <25.

Discussion: MoCA cutoffs <23 to <25 maximized the sum of sensitivity and specificity for detecting MCI. The risk of bias of included studies limits confidence in these findings.

Keywords: Montreal Cognitive Assessment tool; accuracy; mild cognitive impairment; mild neurocognitive disorder; screening.

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References

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