Optimal cut-off scores for the Mini Mental State Examination and Montreal Cognitive Assessment to detect MCI and dementia in Multiple System Atrophy

Topic: Risk, prevention and care in population studies

According to the II level neuropsychological evaluation, 4.8 % of MSA patients met criteria for dementia and 53,2 % for MCI. The optimal MMSE cut-off scores were 20.5 for dementia (AUC = 0.915) and 26.5 for MCI (AUC = 0.698). For MoCA, the most accurate cut-offs were 14.0 to detect dementia (AUC = 0.919) and 19.5 to detect MCI (AUC = 0.702).ROC analysis suggested that both tests were more accurate to identify MCI than dementia. The optimal cut-off for MoCA fluency item to identify MCI was 8.5 words (AUC = 0.717). Our findings support MMSE and MoCA as effective and accessible tools to detect MCI and dementia in MSA. MoCA fluency item emerged as a reliable tool to detect MCI.

Key findings

• According to the II level neuropsychological evaluation, 4.8 % of MSA patients met criteria for dementia and 53,2 % for MCI.
• The optimal MMSE cut-off scores were 20.5 for dementia (AUC = 0.915) and 26.5 for MCI (AUC = 0.698).
• For MoCA, the most accurate cut-offs were 14.0 to detect dementia (AUC = 0.919) and 19.5 to detect MCI (AUC = 0.702).ROC analysis suggested that both tests were more accurate to identify MCI than dementia.
• The optimal cut-off for MoCA fluency item to identify MCI was 8.5 words (AUC = 0.717).
• Our findings support MMSE and MoCA as effective and accessible tools to detect MCI and dementia in MSA.

Why it matters

This study found that the MMSE and MoCA are effective tools to detect mild cognitive impairment and dementia in patients with multiple system atrophy, with specific cutoff scores identified for each condition. The MoCA fluency item emerged as a reliable tool to detect mild cognitive impairment.

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Study details

• Effect sizeAUC = 0.915; AUC = 0.698; AUC = 0.919
• Evidence strengthLow

Read the original

• DOI: 10.1016/j.parkreldis.2025.107974
• PubMed: 40752382
• Original source →
• Free full text: Parkinsonism & Related Disorders →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{cuoco2025-40752382,
  author  = {Cuoco, Sofia and Carotenuto, Immacolata and Russillo, Maria Claudia and Andreozzi, Valentina and Picillo, Marina and Amboni, Marianna and Erro, Roberto and Soricelli, Andrea and others},
  title   = {{Optimal cut-off scores for the Mini Mental State Examination and Montreal Cognitive Assessment to detect MCI and dementia in Multiple System Atrophy}},
  journal = {Parkinsonism \& Related Disorders},
  year    = {2025},
  doi     = {10.1016/j.parkreldis.2025.107974},
  pmid    = {40752382},
  url     = {https://doi.org/10.1016/j.parkreldis.2025.107974}
}

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