A-02 Comparing Rate of Change in MoCA and MMSE Scores Over Time in an MCI and AD sample

Abstract

Abstract Objective The Montreal Cognitive Assessment (MoCA) and Mini-Mental Status Exam (MMSE) are used for tracking cognitive change in mild cognitive impairment (MCI) and Alzheimer’s disease (AD), despite limited empirical support for this purpose. This study compared longitudinal change in MMSE and MoCA scores to investigate their applicability for tracking cognitive change. Method Inclusion criteria were: diagnosis of MCI or AD (CDR global = .5) by consensus conference, administration of the MoCA and MMSE across ≥3 visits, and no reversion to normal (n = 59; Mage = 70.81; Meducation = 14.97; 56% male; 76.3% Caucasian; 80% MCI at baseline). Testing sessions occurred ~ 12 months apart (M = 12.59, SD = 3.43, range 5–28 months). Change in MMSE and MoCA scores was modeled using multilevel regression. A 95% bootstrap confidence interval (BCI) for the slopes of both tests was computed and used to evaluate whether the tests measured significantly different change. Results Controlling for age and education, the MoCA demonstrated significantly more change over time (95% BCI [−0.06, −0.02]; MoCA Visit 1 M = 24.00, Visit 4 M = 21.88) than the MMSE (95% BCI [−0.03, 0.01]; MMSE Visit 1 M = 27.83, Visit 4 M = 27.50). MoCA scores significantly declined over the study period (but did not exceed the reliable change index), while MMSE scores did not. Conclusions The MMSE did not show significant change over time, while the MoCA did in this heavily MCI sample. Although statistically significant, clinical significance of change in the MoCA is unclear. Increasing MoCA use calls for additional research to understand what constitutes a clinically significant change and whether it is appropriate for tracking cognitive trajectories.