, their study only considered a sample of individuals from Santiago de Chile (i.e., HE, mild and major NCD), which might affect the interpretation of results in other cities where prevalence rates are different from those observed in Santiago. Despite the good efficiency statistics reported by Delgado et al. provided normative values, and diagnostic efficiency statistics reporting a cut-off score of 20 to discriminate amnestic mild NCD patients from healthy elderly (HE) participants, with a sensitivity of 75% and a specificity of 82%. Following the SPin criterion (i.e., for a positive test result, a very high specificity rules in the diagnosis ), the low specificity associated with the cut-off score of the Chilean version of the MMSE may lead to high rates of false negative results. suggest that the MMSE is not a suitable screening measure to detect mild NCD, mainly because of its low specificity. However, a recent meta-analysis provided by Ciesielska et al. obtained normative values of the MMSE for the Chilean population, establishing a cut-off score of 21/22 to detect major NCD with a sensitivity of 93.6% and a specificity of 46.1%. Additionally, the existence of metabolic and physiological biomarkers, along with brain imaging techniques, enrich the diagnostic process, especially considering the multiple etiologies underlying neurodegenerative disorders (e.g., Alzheimer disease, Parkinson disease, or frontotemporal lobar degeneration, among others).

Thus, the clinical diagnosis of mild or major NCD is established mainly based on the person’s performance on different cognitive domains, and its functionality in everyday activities. However, it has also been described that cognitive decline observed in major NCD is significantly higher than that described for mild NCD, and it is also accompanied by an important deterioration of daily life activities. consider mild NCD as an intermediate stage of cognitive impairment that is often, but not always, a transitional phase from mild to major NCD. These results showed that the MoCA is a suitable tool to identify mild NCD and major NCD.Ĭlinical evidence indicates that approximately 35% of amnestic mild NCD cases evolve to major NCD after 2 years of onset. Conclusion: Overall diagnostic accuracy can be considered as outstanding (AUC ≥0.904) when discriminating HE from both mild NCD and major NCD. The cut-off between mild NCD and major NCD from HE participants was 19 points with 85.6% of sensitivity and 90.3% of specificity. The observed balance between sensitivity and specificity shows a good test performance either to confirm or discard a diagnosis. Results: The optimal cut-off score to discriminate mild NCD from HE participants was 20 points with a sensitivity of 82.8% and a specificity of 84.1%. Methods: This study included 226 participants from the north, center, and south of the country, classified into 3 groups: healthy elderly (HE n = 113), mild NCD ( n = 65), and major neurocognitive disorder (major NCD n = 48).

In this context, the aim of this study was to update the normative values, and diagnostic efficiency statistics of the MoCA to detect mild NCD in the Chilean population. However, cut-off scores and accuracy indices should be established using representative samples of the population. Background: The Montreal Cognitive Assessment (MoCA) is a sensitive screening instrument for mild neurocognitive disorder (mild NCD).

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