Diagnostic value of montreal cognitive assessment for mild cognitive impairment in Chinese middle-aged adults: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Feiyun ¹ , WANG Yanhong ² , LI Juanjuan ¹ , WANG Li ² , JIANG Yu ¹ ,  LIAO Susu ²

1. Department of Epidemiology & Biostatistics, School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100730, P.R.China;
2. Department of Epidemiology & Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, 100005, P.R.China;

Corresponding author：

LIAO Susu, Email: susuliao@ibms.pumc.edu.cn

Keywords：

The Montreal Cognitive Assessment; Mild cognitive impairment; Chinese population; Diagnostic test; Meta-analysis

DOI：

10.7507/1672-2531.201609052

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate diagnostic accuracy of several relevant cut-off points of Montreal cognitive assessment (MoCA) for mild cognitive impairment (MCI) in Chinese middle-aged adults. Methods Databases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 5, 2016), OVID, CBM, CNKI, VIP, WanFang Data were searched for diagnostic tests about MoCA for MCI from April 9^th 2005 to December 31^st 2015. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality by QUADAS-2 tool. Then, meta-analysis was performed by Stata 14.0 software. Results A total of 27 studies involving 5 755 participants were included with mean ages from 60 to 80 years old. Among them, 1 997 were diagnosed as MCI patients by Petersen criteria. Based on maximal area under the ROC curve as well as optimal pooled sensitivity and specificity, the optimal cutoff value of MoCA was 25/26, the pooled sensitivity was 0.96 with 95%CI 0.93 to 0.97, specificity was 0.83 with 95%CI 0.75 to 0.89, and DOR was 107 with 95%CI 61 to 188. The subgroup analysis with different research designs, different sources of study participants and different MoCA versions all indicated 25/26 as an optimal cut-off value. Conclusion The optimal cutoff value of MoCA in Chinese middle-aged adults for screening MCI by Petersen criteria was 25/26.

Citation： HUANG Feiyun, WANG Yanhong, LI Juanjuan, WANG Li, JIANG Yu, LIAO Susu. Diagnostic value of montreal cognitive assessment for mild cognitive impairment in Chinese middle-aged adults: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(4): 450-457. doi: 10.7507/1672-2531.201609052 Copy

1.	Juebin H, John SM, Zhen ZX,et al. Progression of mild cognitive impairment to Alzheimer's or vascular dementia versus normative aging among elderly Chinese. Curr Alzheimer Res, 2005, 2(5): 571-578.
2.	Li H, Li J, Li N,et al. Cognitive intervention for persons with mild cognitive impairment: A meta-analysis. Ageing Res Rev, 2011, 10(2): 285-296.
3.	Michael V, Perminder S. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry, 2009, 17(17): 179-187.
4.	Simon SS, Yokomizo JE, Bottino CMC. Cognitive intervention in amnestic Mild Cognitive Impairment: A systematic review. Neurosci Biobehav Rev, 2012, 36(4): 1163-1178.
5.	Nasreddine ZS, Phillips NA, Bedirian V,et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
6.	王炜, 王鲁宁. " 蒙特利尔认知评估量表”在轻度认知损伤患者筛查中的应用. 中华内科杂志, 2007, 46(5): 414-416.
7.	Zhao S, Guo C, Wang M,et al. A clinical memory battery for screening for amnestic mild cognitive impairment in an elderly chinese population. J Clin Neurosci, 2011, 18(6): 774-779.
8.	易刚, 肖军, 唐娟娟. 蒙特利尔认知评估量表在成都市社区老年人轻度认知功能障碍筛查中的应用分析. 中国临床心理学杂志, 2011, 19(2): 203-204.
9.	Ciesielska N. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol, 2016, 50(5): 1039-1052.
10.	Petersen RC, Smith GE, Waring SC,et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol, 1999, 56(3): 303-308.
11.	Petersen RC, Stevens JC, Ganguli M,et al. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2001, 56(9): 1133-1142.
12.	Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med, 2004, 256(3): 183-194.
13.	Whiting PF, Rutjes AW, Westnood ME,et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
14.	邬兰, 张永, 曾宪涛. QUADAS-2 在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
15.	Reitsma JB, Glas AS, Rutjes AWS,et al. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol, 2005, 58(10): 982-990.
16.	Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol, 2005, 58(9): 882-893.
17.	沈银, 骆雄, 唐牟尼, 等. 简明精神状态检查和蒙特利尔认知评估量表筛查社区老年人中轻度认知功能障碍及痴呆的应用分析. 中华精神科杂志, 2014, 47(5): 293-297.
18.	张雪晴, 曾慧. 蒙特利尔认知评估量表在老年人轻度认知功能障碍筛查中的截断值分层研究. 中国全科医学, 2014, 17(26): 3046-3051.
19.	姚燕, 杨芳, 王丽娟, 等. 蒙特利尔认知评估量表在轻度认知功能障碍诊断中的应用. 吉林大学学报（医学版）, 2012, 38(4): 730-735.
20.	沈银. 广州地区城乡 65 岁及以上老人轻度认知障碍和痴呆的流行病学调查. 广州: 广州医学院, 2011.
21.	温洪波, 张振馨, 牛富生, 等. 北京地区蒙特利尔认知量表的应用研究. 中华内科杂志, 2008, 47(1): 36-39.
22.	Hu JB, Zhou WH, Hu SH,et al. Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: Preliminary findings. Arch Gerontol Geriatr, 2013, 56(1): 38-43.
23.	孟晓梅, 于逢春, 尹静, 等. 蒙特利尔认知评估量表用于轻度认知功能障碍患者评估的初步研究. 中华老年心脑血管病杂志, 2012, 14(11): 1173-1175.
24.	Yu K, Zhang S, Wang Q,et al. Development of a computerized tool for the chinese version of the montreal cognitive assessment for screening mild cognitive impairment. Int Psychogeriatr, 2015, 27(2): 213-219.
25.	王晓飞, 郁可, 李余霞, 等. 蒙特利尔认知评估中文计算机软件的临床应用. 神经疾病与精神卫生, 2014, 14(4): 353-355.
26.	孔伶俐, 孙忠国, 周田田, 等. 蒙特利尔认知评估量表在轻度认知功能障碍诊断中的应用. 中国健康心理学杂志, 2015, 23(8): 1212-1215.
27.	Tsai CF, Lee WJ, Wang SJ,et al. Psychometrics of the Montreal Cognitive Assessment (MoCA) and its subscales: Validation of the Taiwanese version of the MoCA and an item response theory analysis. Int Psychogeriatr, 2012, 24(4): 651-658.
28.	邵荣, 韩伯军. 蒙特利尔认知评估量表在老年轻度认知功能障碍筛查中的应用. 职业与健康, 2014, 30(20): 2916-2918.
29.	王琦, 毛礼炜, 刘娟, 等. 蒙特利尔认知评估量表在老年轻度认知损害中的应用. 苏州大学学报（医学版）, 2011, 31(4): 655-657.
30.	孙云闯, 秦斌. 中文版 MoCA 和 MMSE 在诊断遗忘型轻度认知功能障碍中的应用. 中国神经免疫学和神经病学杂志, 2011, 18(2): 91-93.
31.	何晓燕, 朱沂, 李红燕, 等. 痴呆评估量表与事件相关电位 p300 对轻度认知功能障碍患者认知功能的评价. 中国老年学杂志, 2011, 31(16): 3041-3043.
32.	王盼, 张熙, 周波, 等. 蒙特利尔认知评价量表(中文版)在轻度认知损害诊断及进展过程中的作用. 中国现代神经疾病杂志, 2012, 12(2): 193-197.
33.	尹立勇. 轻度认知障碍调查与诊断研究. 石家庄: 河北医科大学, 2010.
34.	林锦波, 张云凤, 巫伟忠, 等. 蒙特利尔认知评估量表筛查老年轻度认知功能障碍的价值. 广西医学, 2015, 37(7): 967-968.
35.	袁正洲, 李作孝, 马勋泰, 等. 长沙版蒙特利尔认知评估量表在老年轻度认知障碍筛查中的应用. 西部医学, 2014, 26(6): 741-744.
36.	Chu LW, Ng KHY, Law ACK,et al. Validity of the Cantonese Chinese Montreal cognitive assessment in Southern Chinese. Geriatr GerontolInt, 2015, 15(1): 96-103.
37.	张立秀, 刘雪琴. 蒙特利尔认知评估量表中文版广州市老人院人群划界分探讨. 中国心理卫生杂志, 2008, 22(2): 123-125.
38.	Yeung PY, Wong LL, Chan CC,et al. A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Med J, 2014, 20(6): 504-510.
39.	高欣, 邹晨双, 段春波, 等. 蒙特利尔认知评估量表在北京社区老年人遗忘型轻度认知障碍筛查中的应用. 中国神经免疫学和神经病学杂志, 2014, 21(4): 250-253.
40.	朱文佳, 高中宝, 杨磊, 等. 蒙特利尔认知评估量表筛查轻度认知功能障碍分界值的研究. 中华老年心脑血管病杂志, 2012, 14(5): 500-502.
41.	王炜, 刘丹丹, 高中宝, 等. 蒙特利尔认知评估量表(中文版)在驻京军队离退休干部中界值划分的初步研究. 中华保健医学杂志, 2010, 12(4): 271-273.
42.	邢建丽, 董艳娟, 何跃, 等. 蒙特利尔认知评估量表在军队老年人群中应用的研究. 人民军医, 2011, 54(S1): 38-40.
43.	李海员. 轻度认知功能障碍患者的神经心理学及其血浆 Hcy 水平的研究. 广州: 广州医学院, 2009.
44.	李兰芳, 肖劲松, 章军建, 等. 轻度认知功能障碍常用筛查量表的比较分析. 医学新知杂志, 2011, 21(6): 420-423.
45.	戴海涛. 认知功能量表在轻度认知损害中的应用. 天津: 南开大学, 2010.

1. Juebin H, John SM, Zhen ZX,et al. Progression of mild cognitive impairment to Alzheimer's or vascular dementia versus normative aging among elderly Chinese. Curr Alzheimer Res, 2005, 2(5): 571-578.
2. Li H, Li J, Li N,et al. Cognitive intervention for persons with mild cognitive impairment: A meta-analysis. Ageing Res Rev, 2011, 10(2): 285-296.
3. Michael V, Perminder S. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry, 2009, 17(17): 179-187.
4. Simon SS, Yokomizo JE, Bottino CMC. Cognitive intervention in amnestic Mild Cognitive Impairment: A systematic review. Neurosci Biobehav Rev, 2012, 36(4): 1163-1178.
5. Nasreddine ZS, Phillips NA, Bedirian V,et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
6. 王炜, 王鲁宁. " 蒙特利尔认知评估量表”在轻度认知损伤患者筛查中的应用. 中华内科杂志, 2007, 46(5): 414-416.
7. Zhao S, Guo C, Wang M,et al. A clinical memory battery for screening for amnestic mild cognitive impairment in an elderly chinese population. J Clin Neurosci, 2011, 18(6): 774-779.
8. 易刚, 肖军, 唐娟娟. 蒙特利尔认知评估量表在成都市社区老年人轻度认知功能障碍筛查中的应用分析. 中国临床心理学杂志, 2011, 19(2): 203-204.
9. Ciesielska N. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol, 2016, 50(5): 1039-1052.
10. Petersen RC, Smith GE, Waring SC,et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol, 1999, 56(3): 303-308.
11. Petersen RC, Stevens JC, Ganguli M,et al. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2001, 56(9): 1133-1142.
12. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med, 2004, 256(3): 183-194.
13. Whiting PF, Rutjes AW, Westnood ME,et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
14. 邬兰, 张永, 曾宪涛. QUADAS-2 在诊断准确性研究的质量评价工具中的应用. 湖北医药学院学报, 2013, 32(3): 201-208.
15. Reitsma JB, Glas AS, Rutjes AWS,et al. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol, 2005, 58(10): 982-990.
16. Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol, 2005, 58(9): 882-893.
17. 沈银, 骆雄, 唐牟尼, 等. 简明精神状态检查和蒙特利尔认知评估量表筛查社区老年人中轻度认知功能障碍及痴呆的应用分析. 中华精神科杂志, 2014, 47(5): 293-297.
18. 张雪晴, 曾慧. 蒙特利尔认知评估量表在老年人轻度认知功能障碍筛查中的截断值分层研究. 中国全科医学, 2014, 17(26): 3046-3051.
19. 姚燕, 杨芳, 王丽娟, 等. 蒙特利尔认知评估量表在轻度认知功能障碍诊断中的应用. 吉林大学学报（医学版）, 2012, 38(4): 730-735.
20. 沈银. 广州地区城乡 65 岁及以上老人轻度认知障碍和痴呆的流行病学调查. 广州: 广州医学院, 2011.
21. 温洪波, 张振馨, 牛富生, 等. 北京地区蒙特利尔认知量表的应用研究. 中华内科杂志, 2008, 47(1): 36-39.
22. Hu JB, Zhou WH, Hu SH,et al. Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: Preliminary findings. Arch Gerontol Geriatr, 2013, 56(1): 38-43.
23. 孟晓梅, 于逢春, 尹静, 等. 蒙特利尔认知评估量表用于轻度认知功能障碍患者评估的初步研究. 中华老年心脑血管病杂志, 2012, 14(11): 1173-1175.
24. Yu K, Zhang S, Wang Q,et al. Development of a computerized tool for the chinese version of the montreal cognitive assessment for screening mild cognitive impairment. Int Psychogeriatr, 2015, 27(2): 213-219.
25. 王晓飞, 郁可, 李余霞, 等. 蒙特利尔认知评估中文计算机软件的临床应用. 神经疾病与精神卫生, 2014, 14(4): 353-355.
26. 孔伶俐, 孙忠国, 周田田, 等. 蒙特利尔认知评估量表在轻度认知功能障碍诊断中的应用. 中国健康心理学杂志, 2015, 23(8): 1212-1215.
27. Tsai CF, Lee WJ, Wang SJ,et al. Psychometrics of the Montreal Cognitive Assessment (MoCA) and its subscales: Validation of the Taiwanese version of the MoCA and an item response theory analysis. Int Psychogeriatr, 2012, 24(4): 651-658.
28. 邵荣, 韩伯军. 蒙特利尔认知评估量表在老年轻度认知功能障碍筛查中的应用. 职业与健康, 2014, 30(20): 2916-2918.
29. 王琦, 毛礼炜, 刘娟, 等. 蒙特利尔认知评估量表在老年轻度认知损害中的应用. 苏州大学学报（医学版）, 2011, 31(4): 655-657.
30. 孙云闯, 秦斌. 中文版 MoCA 和 MMSE 在诊断遗忘型轻度认知功能障碍中的应用. 中国神经免疫学和神经病学杂志, 2011, 18(2): 91-93.
31. 何晓燕, 朱沂, 李红燕, 等. 痴呆评估量表与事件相关电位 p300 对轻度认知功能障碍患者认知功能的评价. 中国老年学杂志, 2011, 31(16): 3041-3043.
32. 王盼, 张熙, 周波, 等. 蒙特利尔认知评价量表(中文版)在轻度认知损害诊断及进展过程中的作用. 中国现代神经疾病杂志, 2012, 12(2): 193-197.
33. 尹立勇. 轻度认知障碍调查与诊断研究. 石家庄: 河北医科大学, 2010.
34. 林锦波, 张云凤, 巫伟忠, 等. 蒙特利尔认知评估量表筛查老年轻度认知功能障碍的价值. 广西医学, 2015, 37(7): 967-968.
35. 袁正洲, 李作孝, 马勋泰, 等. 长沙版蒙特利尔认知评估量表在老年轻度认知障碍筛查中的应用. 西部医学, 2014, 26(6): 741-744.
36. Chu LW, Ng KHY, Law ACK,et al. Validity of the Cantonese Chinese Montreal cognitive assessment in Southern Chinese. Geriatr GerontolInt, 2015, 15(1): 96-103.
37. 张立秀, 刘雪琴. 蒙特利尔认知评估量表中文版广州市老人院人群划界分探讨. 中国心理卫生杂志, 2008, 22(2): 123-125.
38. Yeung PY, Wong LL, Chan CC,et al. A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Med J, 2014, 20(6): 504-510.
39. 高欣, 邹晨双, 段春波, 等. 蒙特利尔认知评估量表在北京社区老年人遗忘型轻度认知障碍筛查中的应用. 中国神经免疫学和神经病学杂志, 2014, 21(4): 250-253.
40. 朱文佳, 高中宝, 杨磊, 等. 蒙特利尔认知评估量表筛查轻度认知功能障碍分界值的研究. 中华老年心脑血管病杂志, 2012, 14(5): 500-502.
41. 王炜, 刘丹丹, 高中宝, 等. 蒙特利尔认知评估量表(中文版)在驻京军队离退休干部中界值划分的初步研究. 中华保健医学杂志, 2010, 12(4): 271-273.
42. 邢建丽, 董艳娟, 何跃, 等. 蒙特利尔认知评估量表在军队老年人群中应用的研究. 人民军医, 2011, 54(S1): 38-40.
43. 李海员. 轻度认知功能障碍患者的神经心理学及其血浆 Hcy 水平的研究. 广州: 广州医学院, 2009.
44. 李兰芳, 肖劲松, 章军建, 等. 轻度认知功能障碍常用筛查量表的比较分析. 医学新知杂志, 2011, 21(6): 420-423.
45. 戴海涛. 认知功能量表在轻度认知损害中的应用. 天津: 南开大学, 2010.

Chinese Journal of Evidence-Based Medicine

Diagnostic value of montreal cognitive assessment for mild cognitive impairment in Chinese middle-aged adults: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content