Montreal Cognitive Assessment in Detecting Cognitive Impairment in Chinese Elderly Individuals: A Population-Based Study

TLDR

The Montreal Cognitive Assessment (MoCA) is a brief, sensitive tool for detecting mild cognitive impairment and early dementia in developed countries, yet data from mainland China are scarce. In this population‑based study, MoCA was administered to 8,411 Chinese community residents aged 65 or older, with norms derived after accounting for key demographic factors. Using optimal cutoffs of 13/14 for illiterates, 19/20 for 1–6 years of education, and 24/25 for 7+ years, the MoCA achieved 83.8% sensitivity overall (80.5% for MCI, 96.9% for dementia) and 82.5% specificity for cognitively normal individuals, confirming its validity for screening in elderly Chinese communities.

Abstract

The Montreal Cognitive Assessment (MoCA) has been proved brief and sensitive to screen for mild cognitive impairment (MCI) and early dementia in some developed countries or areas. However, little MoCA data are available from mainland China. In this study, the MoCA was applied to 8411 Chinese community dwellers aged 65 or older (6283 = cognitively normal [CN], 1687 = MCI, and 441 = dementia). The MoCA norms were established considering significant influential factors. The optimal cutoff points were 13/14 for illiterate individuals, 19/20 for individuals with 1 to 6 years of education, and 24/25 for individuals with 7 or more years of education. With the optimal cutoffs, the sensitivity of the MoCA was 83.8% for all cognitive impairments, 80.5% for MCI and 96.9% for dementia, and the specificity for identifying CN was 82.5%. These indicate that with optimal cutoffs, the MoCA is valid to screen for cognitive impairment in elderly Chinese living in communities.