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Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging
Roalf DR, Moberg PJ, Xie SX, Wolk DA, Moelter ST, Arnold SE.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2012-12-21
Topic: Amyloid, tau and blood-test diagnosis
Background The aim of this study was to compare the utility and diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in the diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) in a clinical cohort. Methods Three hundred twenty-one AD, 126 MCI, and 140 older adults with healthy cognition (HC) were evaluated using the MMSE, the MoCA, a standardized neuropsychologic battery according to the Consortium to Establish a Registry of Alzheimer's Disease (CERAD-NB), and an informant-based measure of functional impairment, the Dementia Severity Rating Scale (DSRS). Diagnostic accuracy and optimal cut-off scores were calculated for each measure, and a method for converting MoCA to MMSE scores is presented. Results The MMSE and MoCA offer reasonably good diagnostic and classification accuracy as compared with the more detailed CERAD-NB; however, as a brief cognitive screening measure, the MoCA was more sensitive and had higher classification accuracy for differentiating MCI from HC. Complementing the MMSE or the MoCA with the DSRS significantly improved diagnostic accuracy. Conclusion The findings support recent data indicating that the MoCA is superior to the MMSE as a global assessment tool, particularly in discerning earlier stages of cognitive decline. In addition, we found that overall diagnostic accuracy improves when the MMSE or MoCA is combined with an informant-based functional measure. Finally, we provide a reliable and easy conversion of MoCA to MMSE scores. However, the need for MCI-specific measures is still needed to increase the diagnostic specificity between AD and MCI.
Key findings
- Results The MMSE and MoCA offer reasonably good diagnostic and classification accuracy as compared with the more detailed CERAD-NB; however, as a brief cognitive screening measure, the MoCA was more sensitive and had higher classification accuracy for differentiating MCI from HC.
- Complementing the MMSE or the MoCA with the DSRS significantly improved diagnostic accuracy.
- In addition, we found that overall diagnostic accuracy improves when the MMSE or MoCA is combined with an informant-based functional measure.
Why it matters
The Montreal Cognitive Assessment was more sensitive than the Mini-Mental State Examination for telling mild cognitive impairment from healthy cognition, and adding an informant-based measure improved accuracy for both tests. This is about improving diagnosis, not about treating, curing, or preventing Alzheimer's disease.
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Study details
- Evidence strengthModerate
How this study scored 53/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 398 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.5 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 3 / 6 | Cited 7.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 17 other studies in this library |
| Still being cited | 3 / 4 | Cited 101 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Steven Edward Arnold: h-index 125 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Pennsylvania: institution h-index 1,859 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23260866) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Roalf, D. R., Moberg, P. J., Xie, S. X., Wolk, D. A., Moelter, S. T., & Arnold, S. E. (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1016/j.jalz.2012.10.001
Vancouver
Roalf DR, Moberg PJ, Xie SX, Wolk DA, Moelter ST, Arnold SE. Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2013. doi:10.1016/j.jalz.2012.10.001. PMID: 23260866.
BibTeX
@article{roalf2013-23260866,
author = {Roalf, D. R. and Moberg, P. J. and Xie, S. X. and Wolk, D. A. and Moelter, S. T. and Arnold, S. E.},
title = {{Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2013},
doi = {10.1016/j.jalz.2012.10.001},
pmid = {23260866},
url = {https://doi.org/10.1016/j.jalz.2012.10.001}
}
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