![]() Taken together, a common recommendation is therefore to rely on demographically adjusted norms for specific populations rather than general cutoffs, and this does seem to help improve diagnostic accuracy. There have also been indications that the rate of age-related decline in the cognitively healthy, as reflected by MoCA scores, accelerates after around the age of 80. Variance across samples is however significant, most likely reflecting not only educational, but also socio-demographical and cultural, as well as methodological, differences. A recent meta-analysis pinpointed < 23/30 as the cutoff with best diagnostic accuracy for general differentiation between MCI and normal aging, and others have come to similar conclusions. Suggested cut-offs specifically for individuals at or above their eighties are rare-wider age-spans are typically reported-but this is roughly in line with findings from other American and European studies including octogenarians. ![]() , and education-adjusted cut-offs for MCI (computed as one standard deviation below the mean ), would in their sample fall between < 20/30 to < 23/30. Similarly, mean MoCA performance in 80- to-89-year-olds was 25.1 in the study by Malek-Ahmadi et al. A recent and large American normative study for example found that 53–100% of their participants aged 75 or older scored below 26 points on the MoCA, depending on ethnicity and educational level, and 10 th percentile predicted scores for 85-year-olds ranged from 14 to 22. In addition, the small number of normative studies including individuals 80 years or older have typically found large proportions performing below the traditional cutoff (< 26/30) used to indicate possible cognitive impairment. It has, however, become clear that the MoCA is sensitive not just to MCI, but also to factors such as normal aging and educational attainment, which reduces specificity.Ī one-point correction for≤12 years of education is integrated in the scoring procedure but has been found not to fully correct for the educational attainment. It has therefore become widely used internationally with a wide range of patient populations, in clinical work as well as in research. Since its introduction in 2005, the Montreal Cognitive Assessment (MoCA) has proven an able detector of mild cognitive impairment (MCI), with decidedly better sensitivity than the more commonly used Mini-Mental State Examination (MMSE).
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