Equating Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores: conversion norms from a healthy Italian population sample

Background: This study aimed to provide equating norms for the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) from a sample of healthy Italian adults.

Methods: Four-hundred and seven Italian healthy adults (165 males, 242 females; mean age = 60.61 ± 13.74 years, range= 20-93; mean education = 12.2 ± 4.42 years, range= 4-25) were administered the MMSE and the MoCA. 'MMSE-to-MoCA' and 'MoCA-to-MMSE' conversion tables were derived via log-linear smoothing equi-percentile equating (LSEE). Equivalence between empirical and conversion-derived scores was determined with a two one-sided test (TOST) procedure.

Results: Conversion-derived scores were statistically equivalent to empirical ones for both the MMSE (p = 0.948) and the MoCA (p = 0.437). The LSEE yielded impossible/unreliable conversion estimates for floor scores on both tests, whereas conversions for uppermost scores were highly consistent.

Discussion: The present data will help avoid inter-rater heterogeneity in cross-sectionally and longitudinally adopting either one of the two cognitive screening tests, and to retrospective analyze data collected via either one test or the other.