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Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity
Milani SA, Marsiske M, Cottler LB, Chen X, Striley CW.. Alzheimer's & dementia (Amsterdam, Netherlands), 2018-11-03
Topic: Risk, prevention and care in population studies
Introduction The Montreal Cognitive Assessment (MoCA), scored from 0 to 30, is used as a screening tool for mild cognitive impairment (MCI). The current cutoff (26) may not be optimal among minorities. Methods Data from the National Alzheimer's Coordinating Center Uniform Data Set March 2018 data freeze was used to calculate optimal cutoffs for detection of MCI and dementia by race/ethnic group and education. Results Of the 3895 individuals included, 80.7% were non-Hispanic White, 15.0% were non-Hispanic Black, and 4.2% were Hispanic. Optimal cutoffs for detection of MCI were 25 among non-Hispanic Whites, 24 among Hispanics, and 23 among non-Hispanic Blacks. Optimal cutoffs for detection of dementia were 19 among non-Hispanic Whites and 16 for both non-Hispanic Blacks and Hispanics. Lower educational attainment produced lower optimal cutoffs. Discussion Our findings suggest cutoffs may need to be stratified by race/ethnicity and education to ensure detecting MCI from normal and MCI from dementia.
Key findings
- Results Of the 3895 individuals included, 80.7% were non-Hispanic White, 15.0% were non-Hispanic Black, and 4.2% were Hispanic.
- Discussion Our findings suggest cutoffs may need to be stratified by race/ethnicity and education to ensure detecting MCI from normal and MCI from dementia.
Why it matters
This study found that the best cutoff scores on the Montreal Cognitive Assessment for detecting mild cognitive impairment and dementia differed by race, ethnicity, and education. It is about improving screening accuracy, not about treating, curing, or preventing the disease.
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Study details
- Participants3,895
- Effect size80.7%; 15.0%; 4.2%
- Evidence strengthLow
How this study scored 58/100
Published in a leading specialty journal. Scored zero for study design 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 (Amsterdam, Netherlands)) |
| Journal's citation record | 1 / 4 | Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring: journal h-index 86 (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 | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,895 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 260 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.0 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 4 / 6 | Cited 12.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 3 / 4 | Cited 123 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Catherine W. Striley: h-index 32 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Florida: institution h-index 1,303 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30505927) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
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Read the original
- DOI: 10.1016/j.dadm.2018.09.003
- PubMed: 30505927
- Original source →
- Free full text: Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Milani, S. A., Marsiske, M., Cottler, L. B., Chen, X., & Striley, C. W. (2018). Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity. Alzheimer's & dementia (Amsterdam, Netherlands). https://doi.org/10.1016/j.dadm.2018.09.003
Vancouver
Milani SA, Marsiske M, Cottler LB, Chen X, Striley CW. Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity. Alzheimer's & dementia (Amsterdam, Netherlands). 2018. doi:10.1016/j.dadm.2018.09.003. PMID: 30505927.
BibTeX
@article{milani2018-30505927,
author = {Milani, S. A. and Marsiske, M. and Cottler, L. B. and Chen, X. and Striley, C. W.},
title = {{Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity}},
journal = {Alzheimer's \& dementia (Amsterdam, Netherlands)},
year = {2018},
doi = {10.1016/j.dadm.2018.09.003},
pmid = {30505927},
url = {https://doi.org/10.1016/j.dadm.2018.09.003}
}
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