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Table 2 Cut-offs and diagnostic accuracy for the MoCA score, the MoCA z-score, and the MMSE

From: Enhanced diagnostic accuracy for neurocognitive disorders: a revised cut-off approach for the Montreal Cognitive Assessment

Group Mild+Major NCD vs. NF Mild NCD vs. NF
MoCA score
AUC (95% CI) 0.94 (0.91–0.96) 0.86 (0.81–0.91)
Original cut-off 25/26 25/26
  Correct classification rate 79% 75%
  Sensitivity (95% CI) 94% (94–95%) 86% (84–87%)
  Specificity (95% CI) 63% (60–67%) 63% (60–67%)
Balanced cut-off 24/25 24/25
  Correct classification rate 82% 74%
  Sensitivity (95% CI) 90% (89–90%) 74% (72–76%)
  Specificity (95% CI) 74% (70–77%) 74% (70–76%)
Cut-off; Youden’s index 23/24 23/24
Cut-off; 10th percentile in NCs 23/24 23/24
  Correct classification rate 88% 79%
  Sensitivity (95% CI) 84% (83–85%) 65% (63–67%)
  Specificity (95% CI) 92% (90–94%) 92% (90–94%)
MoCAz-score*
AUC (95% CI) 0.94 (0.91–0.96) 0.86 (0.81–0.91)
Balanced cut-off ≤ − 1.08 ≤ − 0.84
  Correct classification rate 86% 76%
  Sensitivity (95% CI) 86% (85–87%) 76% (74–78%)
  Specificity (95% CI) 86% (83–89%) 76% (73–79%)
Cut-off; Youden’s index ≤ − 1.31 ≤ − 1.14
  Correct classification rate 88% 79%
  Sensitivity (95% CI) 81% (80–82%) 68% (66–70%)
  Specificity (95% CI) 94% (92–96%) 90% (88–92%)
Cut-off; 10th percentile in NCs ≤ − 1.36 ≤ − 1.36
  Correct classification rate 88% 79%
  Sensitivity (95% CI) 80% (79–81%) 61% (59–63%)
  Specificity (95% CI) 96% (95–97%) 96% (95–97%)
MMSE
AUC (95% CI) 0.89 (0.85–0.93) 0.78 (0.72–0.85)
Cut-off; Youden’s index 27/28 28/29
  Correct classification rate 82% 73%
  Sensitivity (95% CI) 72% (71–73%) 69% (67–70%)
  Specificity (95% CI) 92% (90–94%) 76% (72–79%)
  1. Abbreviations: AUC area under the curve, CI confidence interval, NC normal controls, NCD neurocognitive disorder, NF normal findings
  2. Correct classification rate = (sensitivity + specificity)/2
  3. Youden’s index = sensitivity + specificity − 1
  4. *MoCA z-score = demographically corrected standard score [7]