Discriminating Between Mild Cognitive Impairment And Alzheimer'S Disease On The Moca

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between MCI and Alzheimer’s disease (ad) on MoCA subtest scores. Specifically, impaired performance on the clock drawing (i.e., number and hand placement), rhino naming, serial 7’s, word recall, and orientation were suggestive of ad. The aim of the present study is to assess for discrimination patterns in MoCA performance between MCI and ad.Method: Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) and ad groups (n = 1339; 56% female, 89% White, 9% Black, 2% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for MCI (M = 22.01, SD = 3.49) and ad (M = 14.46, SD = 6.05; t(2480) = 38.72, p = 0.000, Cohen’s d = 1.53). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for MCI and ad groups across all MoCA subtests and domains. Despite no discrimination in profiles noted on t-tests, further examination using normal distribution revealed worse performance on trails, clock hands, serial 7’s, repetition, fluency, date, and place in ad groups. Conclusions Consistent with previous findings, clock hands, serial 7’s, and orientation were able to discriminate between ad and MCI. This study found further discrimination in trails, repetition, and fluency. These findings may allow for clinicians to use these patterns of performance as early cognitive markers of impairment.