P1‐427: A community‐based study of the Montreal Cognitive Assessment (MoCA) in Japan: The Kurihara Project
Bibliographic record
Abstract
The Montreal Cognitive Assessment (MoCA) was a new screening instrument for mild cognitive dysfunction. There was a clinic-based study using the MoCA Japanese version (MoCA-J), but no previous community-based studies. The purpose of this study is to examine the validity of the MoCA of old-old people in the community. We obtained the agreement from 229 community dwellers, aged 75+ years in 2010 living in Kurihara, Northern Japan. We utilized Clinical Dementia Rating (CDR), clinical examination, neuropsychological tests and MRI. Of the 229 subjects, there were 98 with a CDR 0 (healthy), 107 with a CDR 0.5 (Mild Cognitive Impairment; MCI), and 24 with a CDR 1+ (dementia). The MCI and dementia groups were significantly older than the healthy group in age (healthy vs. MCI vs. dementia; 78.8 vs. 80.8 vs. 82.6 years (mean); p < 0.001) and lower in educational level (9.5 vs. 8.6 vs. 8.0 years (mean); p < 0.001). We analyzed the differences between the 3 CDR groups in the MoCA, MoCA subscales, and Mini-Mental State Examination (MMSE). There were significant decreases step by step through 3 CDR groups in the MoCA (21.5 vs. 17.6 vs. 12.0; p < 0.001) and MMSE (25.5 vs. 22.9 vs. 16.0; p < 0.001). In MoCA subscales, there were significant decreases step by step through 3 CDR groups in naming, memory (encoding), vigilance, serial 7s, and abstraction (p < 0.05). The MCI and dementia groups had significantly lower scores than the healthy group on alternating Trail Making/visuoconstructional skill and delayed recall (p < 0.05). The dementia group had significantly lower scores than the healthy and MCI groups on orientation (p < 0.05). From the receiver operating characteristic (ROC) curve, the area under the curve (AUC) in the MoCA (healthy vs. MCI+) was 0.78 (p < 0.001), and the cutoff was at 20/21 (sensitivity 0.77, specificity 0.57). These results suggest that the MoCA is an appropriate method of evaluation for detecting MCI subjects and dementia patients in the community. Since the MoCA was affected by older age and lower educational level, the cutoff scores should be re-considered.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".