The Montreal Cognitive Assessment (MoCA) is a popular cognitive screening test designed to detect mild cognitive impairment (MCI) in older adults (Nasreddine et al., 2005). It was originally validated in a normative sample with a mean education of 13.3 years using a cutoff score of 26. Our objective was to obtain normative data in a sample with 12 years or less of education, and to develop alternate forms to facilitate its use in repeated testing. Ninety-six healthy participants without cognitive problems were tested on the original MoCA and a neuropsychological battery. This sample was combined with lower-education participants from the initial validation study. Fifty-five participants were excluded, mainly due to poor neuropsychological performance (score = 1.5 SD below the mean on 1+ measure). The final sample was 79participants. Two alternate MoCA forms were developed by replacing original items with new exemplars. The original and two new forms were administered one month apart in randomized order to 32normal elderly controls, 30 patients with MCI, and 21 patients with Alzheimer disease. 1. Revised education corrections of +1 point for 10-12 years of education (n = 52) and +2 points for4-9 years of education (n = 27) are suggested. Sensitivity for detecting MCI/AD were 90/100% and specificity 69.2%for 10-12 years of education, and 87.5/100% sensitivity, 74.1% specificity for4-9 years of education. 2. Repeated measures ANOVA on the three MoCA forms revealed the following: total scores for the NECs and AD's on all three versions were within 0.8 points of each other, with no significant differences between the versions. Total scores for the MCIs showed a significant but small 1.3point difference between MoCA 1 and MoCA3. The MoCA has lower specificity for detecting MCI in lower education samples, highlighting the challenge of cognitive screening in older adults with lower education but, overall, retains its excellent psychometric properties and sensitivity as a screening tool for MCI and mild AD. The three forms of the MoCA yield equivalent total scores and discriminate MCI patients from controls and AD patients. The three forms are suitable for situations requiring repeated cognitive testing
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Chertkow et al. (2011) studied this question.