A Scoping Review of Clinical Utility from the Montreal Cognitive Assessment Memory Index Score.

Abstract

ObjectiveThe Montreal Cognitive Assessment (MoCA) Memory Index Score (MIS) is a supplemental assessment of memory composed of word list delayed free-recall followed by step-down category cued- and multiple-choice cued-recall. This paper reviews the MIS literature within Alzheimer's and other neurodegenerative dementias to synthesize evidence regarding its clinical utility, identify gaps, and inform future research directions.MethodWe searched electronic databases of OVID Medline, Embase, PsycINFO, and PubMed from 2014, when the MIS was first described, to July 2025. Peer-reviewed studies that reported data on the diagnostic or prognostic utility of the MIS in assessing neurodegenerative dementia populations were included.ResultsWe screened 278 articles, and 14 were included in the review. The current literature includes limited reporting on the diagnostic or prognostic utility of the MIS and is characterized by minimal diversity of samples and non-rigorous validation methods. Initial findings are promising and suggestive of incremental validity over the MoCA total score for identifying episodic memory impairment and therefore aiding in differentiation of suspected dementia etiology. However, evidence is insubstantial for the MIS as a tool for predicting progression and additional research is needed to evaluate the incremental validity of the MIS over the conventional MoCA five-word recall score.ConclusionsLarge literature gaps exist regarding the clinical utility of the MIS within neurodegenerative dementias. Additional research exploring the psychometric properties of the MIS using diverse samples with rigorous validation methods is needed to better inform its application.