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Original Article
Dementia and Neurocognitive Disorders 2023: 22: 2: 69-77

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Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination
Haeyoon Kim , 1,2 Seonyeong Yang , 1 Jaesel Park , 1,3 Byeong Chae Kim , 2 Kyung-Ho Yu , 3 Yeonwook Kang 1
1 Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea 2 Department of Neurology, Choennam National University Hospital, Gwangju, Korea 3 Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination
Haeyoon Kim , 1,2 Seonyeong Yang , 1 Jaesel Park , 1,3 Byeong Chae Kim , 2 Kyung-Ho Yu , 3 Yeonwook Kang 1
1 Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea 2 Department of Neurology, Choennam National University Hospital, Gwangju, Korea 3 Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
Background and Purpose: The Montreal Cognitive Assessment (MoCA) has been known as a
screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State
Examination (MMSE). However, in previous domestic studies, no significant difference was
found in the discriminability between MoCA and MMSE. Researchers have suggested that
this might be because older Koreans are less educated than older Westerners. This study was
conducted to examine the effect of education on the discriminability of MoCA compared to
the MMSE.
Methods: Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with
amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer’s type.
The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple
regression analyses and receiver operating characteristic (ROC) curve analyses were
performed.
Results: In all participants, education significantly affected both K-MoCA and K-MMSE
scores along with age. The effect of education was re-examined by subgroup analysis after
dividing subjects according to the level of education. Effect of education on K-MoCA and
K-MMSE was only shown in the group with <9 years of education. ROC curve analyses
revealed that the discriminability of K-MoCA to differentiate between vascular MCI and
normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups
divided by education level, however, this higher discriminability of K-MoCA disappeared in
the group with <9 years of education.
Conclusions: These results indicate no difference in discriminating cognitive deficits
between K-MoCA and K-MMSE in Korean elderly with <9 years of education.
Key Words: MoCA; MMSE; Discriminability; Education; MCI
대한치매학회지 (Dementia and Neurocognitive Disorders)