Comparison of the Diagnostic Accuracy of Neuropsychological Tests in Differentiating Alzheimer's Disease from Mild Cognitive Impairment: Can the Montreal Cognitive Assessment Be Better than the Cambridge Cognitive Examination?

OBJECTIVE: Considering the lack of studies on measures that increase the diagnostic distinction between Alzheimer's disease (AD) and mild cognitive impairment (MCI) and on the role of the Cambridge Cognitive Examination (CAMCOG) in this, our study aims to compare the utility of the CAMCOG, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in helping to differentiate AD from MCI in elderly people with >4 years of schooling. METHOD: A total of 136 elderly subjects – 39 normal controls as well as 52 AD patients and 45 MCI patients treated at the Institute of Geriatrics and Gerontology, Porto Alegre, Brazil – were assessed using the MMSE, CAMCOG, clock drawing test (CDT), verbal fluency test (VF), Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire. RESULTS: The results obtained by means of a receiver operating characteristic curve showed that the MoCA is a better screening test for differentiating elderly subjects with AD from those with MCI than the CAMCOG and MMSE as well as other tests such as the CDT and VF. CONCLUSION: The MoCA, more than the CAMCOG and the other tests, was shown to be able to differentiate AD from MCI, although, as Roalf et al. [Alzheimers Dement 2013;9:529-537] pointed out, further studies might lead to measures that will improve this differentiation.