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  1. AJ Larner
  1. The Walton Centre


Objective To compare diagnostic accuracy of the Mini-Addenbrooke's Cognitive Examination (M-ACE) and Montreal Cognitive Assessment (MoCA) for diagnosis of dementia and mild cognitive impairment (MCI) in a cognitive disorders clinic.

Results Of 117 consecutive new referrals seen over 6 months (June-November 2015; F:M=49:68, 42% female; age range 27–89 years, median 60), 20 were diagnosed with dementia (DSM-IV-TR criteria), 34 with MCI (Petersen criteria). M-ACE and MoCA scores were highly correlated (0.86). Using cutoffs defined in index studies (M-ACE ≤25/30; MoCA <26/30), both M-ACE and MoCA were sensitive (>0.90) but not specific (<0.6) for dementia and MCI diagnosis. Area under ROC curve was >0.8 for both tests for both diagnoses. Effect size (Cohen's d) r was large for dementia (M-ACE 1.62; MoCA 1.91) and MCI diagnosis (M-ACE 1.12; MoCA 1.31). Weighted comparison suggested very small net loss for M-ACE vs MoCA for dementia diagnosis (−0.026; equivalent increase 4.4 extra patients diagnosed per 1000 screened using MoCA) and very small net benefit for M-ACE vs MoCA for MCI diagnosis (0.013; equivalent increase 4.6 extra patients diagnosed per 1000 screened using M-ACE).

Conclusions In this pragmatic study, M-ACE and MoCA showed comparable metrics for diagnosis of dementia and MCI.

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