Examining the Effects of Formal Education Level on the Montreal Cognitive Assessment

Journal of the American Board of Family Medicine: JABFM

article

Renee S. White¹  Justin M. Barber¹  Jordan P. Harp¹  Gregory A. Jicha¹ 

[1]Sanders-Brown Center on Aging, University of Kentucky

[2]Lithuanian University of Health Sciences

关键词: Clinical Medicine;    Cognition;    Cognitive Aging;    Geriatrics;    Montreal Cognitive Assessment;    Neuropsychology;    Psychometrics;   

DOI  :  10.3122/jabfm.2022.220093R1

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Background: Brief, global assessments such as the Montreal Cognitive Assessment (MoCA) are widely used in primary care for assessing cognition in older adults. Like other neuropsychological instruments, lower formal education can influence MoCA interpretation.Methods: Data from 2 large studies of cognitive aging were used—Alzheimer’s Disease Neuroimaging Initiative (ADNI) and National Alzheimer’s Coordinating Center (NACC). Both use comprehensive examinations to determine cognitive status and have brain amyloid status for many participants. Mixed models were used to account for random variation due to data source.Results: 12 years) to be classified as potentially impaired using the MoCA cutoff of <26 (P < .01). Backwards selection revealed 4 MoCA items significantly associated with education (cube copy, serial subtraction, phonemic fluency, abstraction). Subtracting these items scores yielded an alternative MoCA score with a maximum of 24 and a cutoff of ≤19 for classifying participants with mild cognitive impairment. Using the alternative MoCA score and cutoff, among cognitively intact participants, both education groups were similarly likely to be classified as potentially impaired (P  .67).Conclusions: The alternative MoCA score neutralized the effects of formal education. Although further research is needed, this alternative score offers a simple procedure for interpreting MoCAs administered to older adults with ≤12 years education. These educational effects also highlight that the MoCA is part of the assessment process—not a singular diagnostic test—and a comprehensive workup is necessary to accurately diagnose cognitive impairments.

【 授权许可】

CC BY