To investigate whether the Montreal Cognitive Assessment (MoCA)- cognitive domain index score (CDIS) was able to find out the mild cognitive impairment (MCI) patients in the elderly.

Total 152 old patients were enrolled in this research from May 2009 to July 2015 in Jiangsu Provincal Geriatrics Research Institute, including normal control group (NC group,n=94) and MCI group(n=58, there were 35 mix MCI patients and 23 amnestic MCI patients). According to the formula published, we calculated the CDIS for memory (MoCA MIS), executive (MoCA LIS), visuospatial (MoCA VIS), language (MoCA LIS), attention (MoCA AIS), and orientation function (MoCA OIS) of the subjects. The total score and CDIS were compared between groups. We calculated and compared the difference in sensitivity and the specificity of each CDIS by counting the AUC of ROC.T-test or Chi-Square was further used to dertermined differences between two groups.

The scores of MoCA total scores (MoCATS) and each subentries and CDIS in the CN group were 27.0±1.9、4.4±0.9(visuo space)、3.0±0.2(name)、2.9±0.3(attention)、2.8±0.5(calculation)、2.1±0.8(language)、1.8±0.4(abstraction)、4.0±0.9(delay memory)、5.9±0.4(orientation)、13.5±2.0(MoCA MIS)、12.1±1.1(MoCA EIS)、6.6±0.7(MoCA VIS)、5.0±0.8(MoCA LIS)、15.4±1.9(MoCA AIS)、5.9±0.4(MoCA OISA). The scores of MoCA total scores (MoCATS) and each subentries and CDIS in the MCI group were 22.2±3.1、3.5±1.3(visuo space)、2.8±0.5 (name)、2.7±0.6 (attention)、2.7±0.6(calculation)、1.8±0.7(language)、1.7±0.6(abstraction)、1.3±0.3(delay memory)、5.4±0.9(orientation)、7.8±3.4(MoCA MIS)、10.9±1.7(MoCA EIS)、5.9±1.1(MoCA VIS)、4.6±0.9 (MoCA LIS)、13.5±2.8(MoCA AIS)、5.4±0.9(MoCA OISA). The scores of MoCA total scores (MoCATS) and each subentries and CDIS in the mix MCI group were 20.8±2.8、2.8±1.0(visuo space)、2.7±0.5(name)、2.5±0.6(attention)、2.6±0.7(calculation)、1.7±0.8(language)、1.6±0.7(abstraction)、1.2±1.2(delay memory)、5.2±1.0 (orientation)、7.7±3.2(MoCA MIS)、10.0±1.4(MoCA EIS)、5.4±1.1(MoCA VIS)、4.5±1.0(MoCA LIS)、12.4±2.8(MoCA AIS)、5.2±1.0(MoCA OISA).There were significant differences in all CDIS and almost all subentries of MoCA between CN groups and MCI group except the scores of calculation and language (t=10.709、4.508、2.639、3.256、1.991、13.845、3.380、11.626、5.002、4.299、2.962、4.500、3.380,P<0.05 or 0.01). There was significant difference in all CDIS and all subentries of MoCA between CN groups and mix MCI group (t=12.263、8.291、2.303、3.548、2.132、2.357、2.066、12.336、3.668、10.104、8.309、5.753、3.133、5.898、3.668,P<0.05 or 0.01). The diagnostic effectiveness of MoCAMIS was as good as MoCATS as there were no difference of AUC between them (P>0.05). The AUC of other CDIS were significantly smaller than MoCATS/ MoCA MIS. The sensitivity of MoCAMIS was 91.5% and the specificity was 89.5% when the cutoff was 11. The sensitivity of MoCATS was 88.3% and the specificity was 84.5% when the cutoff was 25. Either sensitivity or specificity of MoCAMIS was better than MoCATS.

The MoCA cognitive domain index score can well present the impairment of cognitive domain in the MCI patients in clinical work.