Trajectories of MMSE and MoCA scores across the healthy adult lifespan in the Italian population

Background: 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.

Methods: The MMSE and MoCA were administered to 407 Italian healthy native-speakers (165 males; age range 20-93 years; education range 4-25 years). 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.

Results: 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). 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. By contrast, MMSE scores failed in capturing the expected age-related trajectory, reaching a plateau in the aforementioned age classes.

Discussion: The MoCA seems to be more sensitive than the MMSE in detecting age-related physiological decline of cognitive functioning across the healthy adult lifespan. The MoCA might be therefore more useful than the MMSE as a test for general cognitive screening aims.