Validity of MOCA and MMSE in Parkinsons disease

Hoops S et al.  Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease.  Neurology 2009; 73:1738-1745. 

MoCA is better than MMSE in MCI and AD in general population.  Using a cutoff score of less than or equal to 25 on the MoCA in PD found that 52 % of patients with normal MMSE had impairment using this point.  MoCA has good test-retest reliability, interrater reliability, and convergent validity with a neuropsychological battery ina small sample of patients with PD.   This study looked at discriminant validity using 132 subjects (NC 92, mci 23, pdd 17).  MoCA and MMSE performance for subjects with cognitive deficits on neuropsych testing  without self report of cognitive decline showed no differences between the 2 tests.  HOWEVER, EXAMINING MoCA SUBSCORE, PATIENTS WITH MCI OR PDD HAD SIGNIFICANTLY LOWER VISUOSPATIA/EXECUTIVE, ATTENTION, LANGUAGE, DELAYED RECALL, AND ORIENTATION SUBSCORES. 

Discussion-- MoCA has good discriminant validity and performs similarly to MMSE overall, but is superior as a screening instrument.  The optimal screening point cutoff for detection of any cognitive disorder for MoCA had greater specificity (.53)