What are cognitive function tests?

From the Guidelines

The Montreal Cognitive Assessment (MoCA) is the most recommended cognitive function test for detecting mild cognitive impairment and dementia due to its high diagnostic accuracy and sensitivity to detect MCI in individuals with average or above levels of education. When evaluating cognitive function, several tests can be used, including the Mini-Mental State Examination (MMSE), MoCA, Trail Making Test, and Clock Drawing Test 1. The MoCA is a 20-item test that assesses multiple cognitive domains, including orientation, memory, language, attention, visuospatial, and executive functions, and usually takes 12 to 15 minutes to administer 1. Some of the key benefits of the MoCA include:

• High diagnostic accuracy for identifying persons with cognitive impairment or dementia 1
• Ability to detect MCI in most individuals with average or above levels of education 1
• Availability of training and certification on the use of the MoCA online 1
• Ability to calculate domain-specific index scores for performance on memory, attention, orientation, executive function, language, and visuospatial cognition 1 In contrast, the Clock Drawing Test has acceptable diagnostic accuracy for detection of cognitive impairment, but it is validated as a screening test, not a diagnostic test, and may have low sensitivity to detect MCI in more intellectually capable individuals 1. Overall, the MoCA is a valuable tool for healthcare providers to evaluate cognitive function and guide treatment decisions for conditions like dementia, Alzheimer's disease, or other neurological disorders 1.

From the Research

Cognic Function Tests

• The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) are two commonly used tests to assess cognitive function in older adults 2, 3.
• The MoCA was developed to enable earlier detection of mild cognitive impairment (MCI) relative to the MMSE, and has been shown to have high sensitivity and specificity for detecting MCI 3.
• A study found that a MoCA score of 18 was equivalent to an MMSE score of 24, and that a cutoff score of 17 on the MoCA may help capture early and late MCI cases 2.
• The MMSE has been used to assess cognitive function in patients with Alzheimer's disease, and has been shown to be effective in detecting cognitive decline 4, 5.
• Other tests, such as the Standardized Mini-Mental State Examination (SMMSE) and the Bristol Activities of Daily Living Scale (BADLS), have also been used to assess cognitive function and daily living activities in patients with Alzheimer's disease 4.

Comparison of Cognic Function Tests

• A study compared the MoCA and MMSE in patients with MCI and Alzheimer's disease, and found that the MoCA was more sensitive than the MMSE in detecting MCI 3.
• Another study found that the MoCA and MMSE were more similar for dementia cases, but the MoCA distributed MCI cases across a broader score range with less ceiling effect 2.
• The SMMSE and BADLS have been used to assess cognitive function and daily living activities in patients with moderate to severe Alzheimer's disease, and have been shown to be effective in detecting cognitive decline and functional impairment 4.

Treatment and Cognic Function Tests

• Cholinesterase inhibitors, such as donepezil, and NMDA receptor antagonists, such as memantine, are commonly used to treat Alzheimer's disease 4, 5, 6.
• A study found that combining memantine and donepezil had an additive effect on cognitive function and daily living activities in patients with moderate to severe Alzheimer's disease 5.
• Another study found that a fixed-dose combination of memantine and donepezil improved adherence to medication and reduced caregiver burden in patients with moderate to severe Alzheimer's disease 6.