Validation of the Italian version of Montreal Cognitive Assessment (MoCA) in routine clinical practice in community dweller older adults residing in the central area of Sicily

Abstract Background/Objective: The aim of the study was to examine Montreal Cognitive Assessment (MoCA) performance in subjects with normal global cognition according to the Mini Mental State Examination (MMSE) in routine clinical practice. Methods: This was a prospective, clinical validation study in 302 consecutive subjects, referring to our dementia centre for suspected cognitive impairment over a six-month period. The MMSE and the MoCA were administered within two hours of each other. Results: 184 (60.91%) of 302 evaluated subjects with a MMSE score between 26 and 30/30 had a pathological MoCA score (< 26). 112/184 (60.84%) patients with a MMSE score between 26 and 29/30 obtained MoCA scores below the norm; 72/184 (39.13%) patients with a 30/30 MMSE had a MoCA score below the norm. Recall (p <.0001) and attention (p<.0001) were the domains that differed significantly on the two screening instruments. Conclusion: The additional use of MoCA, as a global assessment tool for the initial screening process, has allowed the identification of patients with cognitive deficit, despite their performance at MMSE had been the norm. Keywords: MoCA, MMSE, Cognitive Screening Test.