The Italian MMSE and MoCA were administered to every participant in a randomized order. Participants had no history of (1) neurological/psychiatric disorders, (2) active psychotropic medications, (3) uncompensated, severe metabolic/internal conditions, (4) organ/system failures and (5) un-corrected vision and hearing deficits. Sample stratification is shown in Supplementary Table 1. The sample consisted in 407 Italian native-speakers (165 males, 242 females), with a mean age of 60.61 ± 13.74 years (range 20–93 years) and a mean education of 12.2 ± 4.42 years (range 4–25 years), who were recruited from different regions of Northern Italy. , the MoCA would outperform the MMSE as to the capability of detecting age-related physiological decline of cognitive functioning across the healthy adult lifespan also in the Italian population, based on the notion of the MoCA being “more difficult” to execute, and thus coming with a greater sensitivity when compared to the MMSE. Specifically, within this work, it was postulated that, in line with the findings of Gluhm et al. Given that in Italy such data have not been provided yet, this study aimed at comparing MMSE and MoCA scores across the healthy adult lifespan in a large Italian population sample. , who showed that, in healthy English adults aged from 20 to 89 years, the MoCA was superior to the MMSE in cross-sectionally profiling involutional cognitive trajectories across age decades. To date, such an investigation has been only performed by Gluhm et al. Hence, within the framework of cognitive screening, a first step for such requirements to be met would be to provide country-specific data on the performance on the MMSE and MoCA across the healthy adult lifespan, in order to explore their capability at detecting age-related, physiological changes in cognitive functioning and thus their feasibility for general-population screening aims. Īccording to the World Health Organization (WHO), for a general-population screening program to be implemented, “ there should be a suitable diagnostic test that is available ”, as well as “an agreed policy, based on respectable test findings and national standards ” ( ). By contrast, the Montreal Cognitive Assessment (MoCA), as widespread as the MMSE, has been highlighted as more sensitive than specific, and thus appropriate to detect even subtle cognitive changes when screening putatively healthy individuals. However, less consensus has been reached as to which test is most suitable to this aim : the Mini-Mental State Examination (MMSE), despite being the most widespread cognitive screening test worldwide, has been questioned as to its feasibility in primary care, as being heavily subjected to ceiling effects and thus scarcely sensitive to sub-clinical deficits. There is an overall favor among European, and especially Italian, healthcare practitioners towards the relevance of screening for cognitive impairment in asymptomatic adults within primary care settings, due to its beneficial entailments in respect to a timely intervention. The MoCA might be therefore more useful than the MMSE as a test for general cognitive screening aims. The MoCA seems to be more sensitive than the MMSE in detecting age-related physiological decline of cognitive functioning across the healthy adult lifespan. By contrast, MMSE scores failed in capturing the expected age-related trajectory, reaching a plateau in the aforementioned age classes. The Age* Test interaction ( p < 0.001) indicates that the MoCA proved to profile a sufficiently linear involutional trend in cognition with advancing age and to be able to detect poorer cognitive performances in individuals aged ≥ 71 years. MMSE and MoCA total scores declined with age ( p < 0.001), with the MoCA proving to be “more difficult” than the MMSE ( p < 0.001). A generalized Negative Binomial mixed model was run to profile MMSE and MoCA scores across 8 different age classes (≤ 30 31–40 41–50 51–60 61–70 71–80 81–85 ≥ 86) net of education and sex. The MMSE and MoCA were administered to 407 Italian healthy native-speakers (165 males age range 20–93 years education range 4–25 years). This study compares the performance at the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) across the healthy adult lifespan in an Italian population sample.
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