What is it about?

This study evaluates how well the Montreal Cognitive Assessment detects patients with Mild Cognitive Impairment due to Alzheimer's Disease (AD). By analyzing age- and education-adjusted test results from patients and healthy individuals, our research pinpoints the most effective cut-points potentially improving diagnostic accuracy in secondary care settings.

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Why is it important?

Clinicians still rely on normative data to interpret neuropsychological test scores. The arbitrarily assigned cut-points to normative distributions maximize the capability to identify individuals without the target condition, meaning its specificity. As a result, only patients in advanced stages of dementia test positive. When tests are applied in this way, they tend to miss patients with early stages of dementia, such as Mild Cognitive Impairment (MCI). Here, we not only validate this assumption but also propose cut-offs that provide a better balance between sensitivity and specificity for patients diagnosed with MCI due to Alzheimer's disease.

Perspectives

Writing this article has been both thrilling and fulfilling. Beyond the practical implications, our goal was to create a piece that is both educational and intentionally thought-provoking. We hope to challenge neuropsychology clinicians and researchers to embrace medical statistics, urging them to dive deeper into the intricacies of diagnostic research rather than staying comfortably within the bounds of normative studies.

Ciro Rosario Ilardi
IRCCS SYNLAB SDN, Naples, Italy

Read the Original

This page is a summary of: On the Clinimetrics of the Montreal Cognitive Assessment: Cutoff Analysis in Patients with Mild Cognitive Impairment due to Alzheimer’s Disease, Journal of Alzheimer s Disease, August 2024, IOS Press,
DOI: 10.3233/jad-240339.
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