Cognitive Performance on the Mini-Mental State Examination and the Montreal Cognitive Assessment Across the Healthy Adult Lifespan

OBJECTIVE: We sought to compare age-related performance on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) across the adult lifespan in an asymptomatic, presumably normal, sample. BACKGROUND: The MMSE is the most commonly used brief cognitive screening test; however, the MoCA may be better at detecting early cognitive dysfunction. METHODS: We gave the MMSE and MoCA to 254 community-dwelling participants ranging in age from 20 to 89, stratified by decade, and we compared their scores using the Wilcoxon signed rank test. RESULTS: For the total sample, the MMSE and MoCA differed significantly in total scores as well as in visuospatial, language, and memory domains (for all of these scores, P<0.001). Mean MMSE scores declined only modestly across the decades; mean MoCA scores declined more dramatically. There were no consistent domain differences between the MMSE and MoCA during the third and fourth decades; however, significant differences in memory (P<0.05) and language (P<0.001) emerged in the fifth through ninth decades. CONCLUSIONS: We conclude that the MoCA may be a better detector of age-related decrements in cognitive performance than the MMSE, as shown in this community-dwelling adult population.