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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

GroupMild+Major NCD vs. NFMild NCD vs. NF
MoCA score
AUC (95% CI)0.94 (0.91–0.96)0.86 (0.81–0.91)
Original cut-off25/2625/26
  Correct classification rate79%75%
  Sensitivity (95% CI)94% (94–95%)86% (84–87%)
  Specificity (95% CI)63% (60–67%)63% (60–67%)
Balanced cut-off24/2524/25
  Correct classification rate82%74%
  Sensitivity (95% CI)90% (89–90%)74% (72–76%)
  Specificity (95% CI)74% (70–77%)74% (70–76%)
Cut-off; Youden’s index23/2423/24
Cut-off; 10th percentile in NCs23/2423/24
  Correct classification rate88%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 rate86%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 rate88%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 rate88%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 index27/2828/29
  Correct classification rate82%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]