Limitations Found in Cognitive Assessment Test

Limitations Found in Cognitive Assessment Test

The Montreal Cognitive Assessment (MoCA) is a commonly used screening test for cognitive impairment in older adults. However, MoCA results may be influenced by educational, language, and cultural factors, so whether the test works well in diverse populations has not been clear.

To find out, Marnina Stimmel, Ph.D., and her colleagues tested the MoCA on a traditionally underserved and multicultural population of 231 Bronx-based older adults with an average age of 73. The MoCA test results were compared with the participants’ scores on “gold standard” neuropsychological tests. The researchers found that the MoCA test’s published cut off scores may be too high, resulting in significant overidentification of cognitive impairment, particularly in Spanish-speaking patients (an overall false positive rate of 79%). They concluded that using lower cut points on the MoCA test may improve the test’s accuracy in identifying cognitive impairment in traditionally underserved, multicultural older individuals. Their study published online on January 10 in the Journal of the American Geriatrics Society.

Dr. Stimmel is a clinical and research neuropsychologist at Einstein and Montefiore Medical Center.