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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