Their varying degrees of sensitivity create the biggest difference and likely become the biggest factor for determining which one is used. “Patients with only minor cognitive impairment may be overlooked if this is the principal screening tool used.” “That’s certainly fine as a composite measure over time, but the MMSE is relatively insensitive to mild disease,” says Roy Hamilton, MD, MS, an assistant professor of neurology at the University of Pennsylvania in Philadelphia. More pressed for time, an internist or a primary care physician would likely conduct only one-probably the MMSE-which would be periodically repeated to test for potential decline. Many memory clinics and neurologists administer both tests as well as a host of others. Neither test is very detail oriented and both would likely be used only for initial screening. The MoCA takes approximately 10 to 12 minutes. They are both brief, though the MMSE is a little shorter, taking about seven to eight minutes to administer. Similar But Differentīoth the MMSE and the MoCA are routine cognitive screening tests rated on a 30-point scale. Physicians say caretakers and other professionals can help put their patients at ease by stressing that these tests are only meant to help. Like any test, especially those assessing cognitive abilities, the thought of participating can make older adults anxious. Lessig’s study found that the MoCA is more sensitive to subtle cognitive deficits in patients with Parkinson’s disease compared with the MMSE, though the MMSE is the more commonly used test. For instance, the MMSE has a heavy language component, but that’s not an area that tends to be as much a deficit of conditions like Parkinson’s or other forms of dementia, so that’s where the MoCA comes in at being a little more sensitive.” It seems to be a little better at looking in depth at some of the deficits that the MMSE might not pick up. “The MoCA has since gone on to be used for other diseases as well. “The MoCA is newer to the scene and originally just looked at patients with milder forms of Alzheimer’s,” explains Stephanie Lessig, MD, an assistant clinical professor at UCSD Neurosciences and VA Medical Center, who was lead author on a comparative study examining the use of the MoCA vs. Assessing many of the same areas as the MMSE, the MoCA is a little more in depth and includes tasks such as a clock-drawing test and a trail test (connecting the dots). Today, the Montreal Cognitive Assessment (MoCA), a newer test created in 1996, is also available. Created by renowned psychiatrist Marshal Folstein, MD, and introduced in 1975, the MMSE tests cognitive function by examining orientation, word recall, language abilities, attention and calculation, and visuospatial ability. In the past, testing for Alzheimer’s disease and other cognitive issues often meant turning to the Mini-Mental State Exam (MMSE) before any further testing was undertaken. The Montreal Cognitive Assessment, used to evaluate cognitive abilities, can better discern some deficits than the Mini-Mental State Exam.

Moca versus mmse test scores