Measurement error, reliability and minimum detectable change in MMSE, MoCA and Color Trails Test among community living middle aged and older adults

Feeney, Joanne, Savva, George, O'Regan, Claire, King-Kallimanis, Bellinda, Cronin, Hilary and Kenny, Rose Anne (2016) Measurement error, reliability and minimum detectable change in MMSE, MoCA and Color Trails Test among community living middle aged and older adults. Journal of Alzheimer's Disease, 53 (3). pp. 1107-1114. ISSN 1387-2877

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Abstract

Background: Knowing the reliability of cognitive tests, particularly those commonly used in clinical practice, is important in order to interpret the clinical significance of a change in performance or a low score on a single test. Objective: To report the intra-class correlation (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) for the Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT) among community dwelling older adults. Methods: 130 participants aged 55 and older without severe cognitive impairment underwent two cognitive assessments between two and four months apart. Half the group changed rater between assessments and half changed time of day. Results: Mean (standard deviation) MMSE was 28.1 (2.1) at baseline and 28.4 (2.1) at repeat. Mean (s.d.) MoCA increased from 24.8 (3.6) to 25.2 (3.6). There was a rater effect on CTT, but not on the MMSE or MoCA. The SEM of the MMSE was 1.0, leading to an MDC (based on a 95% confidence interval) of 3 points. The SEM of the MoCA was 1.5, implying an MDC95 of 4 points. MoCA (ICC=0.81) was more reliable than MMSE (ICC=0.75), but all tests examined showed substantial within-patient variation. Conclusion: An individual’s score would have to change by greater than or equal to 3 points on the MMSE and 4 points on the MoCA to be confident that the change was not due to measurement error. This has important implications for epidemiologists and clinicians in dementia screening and diagnosis.

Item Type: Article
Uncontrolled Keywords: cognition,aging,reliability,measurement error
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Related URLs:
Depositing User: Pure Connector
Date Deposited: 10 May 2016 11:00
Last Modified: 22 Apr 2020 01:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/58620
DOI: 10.3233/JAD-160248

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