Utility of combination of Mini-Mental State Examination and Montreal Cognitive Assessment to predict incident Alzheimer's disease dementia in patients at high vascular risks

Abstract

Background

Screening for cognitive function, using tests such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), is the first step in detecting mild cognitive impairment (MCI) and dementia. However, the sensitivity of detecting MCI patients who will develop incident Alzheimer's disease (AD) dementia in the near future is low.

Objective

This study aimed to clarify the utility of the combination of the MMSE and MoCA in selecting patients at a high risk of incident AD dementia.

Methods

In this post-hoc analysis, we derived data from a Japanese observational registry of patients with vascular risk factors. The primary outcome was incident AD dementia. The accepted cutoff values of an MMSE score of 28 and an MoCA score of 26 for MCI were considered.

Results

After excluding those who did not undergo the test, 940 patients were included. During a median follow-up period of 4.6 years, incident AD dementia occurred in 49 patients. Patients diagnosed with MCI with MMSE scores <28 or MoCA scores <26 showed a significantly higher risk of AD dementia than those with normal MMSE or MoCA groups. However, patients who met the MCI criteria in only one test showed a risk similar to that of the normal group. In contrast, patients who met the MCI criteria for MMSE and MoCA scores had a 20.65-fold higher risk than those with normal MMSE and MoCA scores.

Conclusions

Patients who met the MCI criteria for both the MMSE and MoCA were highly susceptible to incident AD dementia.

Clinical Trial Registration

UMIN000026671