C-03 The sensitivity and specificity of the Montreal Cognitive Assessment is Age Dependent for Amyloid Positivity in a Mixed Clinical Sample
Bibliographic record
Abstract
Abstract Objective The Montreal Cognitive Assessment (MoCA) is a widely-used screening tool for neurodegenerative disorders. Despite widespread use, there have been few investigations into correlations between MoCA and biomarkers of Alzheimer's disease pathology. This study examined the relationship between MoCA performance and the presence of amyloid as detected by positron emission tomography (PET). Methods Sensitivity and specificity for the total MoCA score were determined for 76 individuals (26 amyloid-negative, 50 amyloid- positive) who were between the ages of 55 and 90 and diagnosed with MCI or mild dementia with a CDR score of 0-1 and were participating in a longitudinal, observational study at the Cleveland Clinic Lou Ruvo Center for Brain Health. All individuals underwent an amyloid PET scan and cognitive screening. Results Sensitivity and specificity for the total score were determined using amyloid positivity as the standard. A cutpoint of 25 yielded the best balance between sensitivity and specificity (74% and 74%, respectively). A total score of 27 was required to achieve 90% sensitivity to identify amyloid positive individuals (i.e. only a 10% risk that individuals with a score of 28-30 have a positive scan). A score of 26 was required in individuals over the age of 75. Conclusions With the emergence of new diagnostic biomarkers, there is need to define the utility of affordable, widely-available screening tools. In this mixed clinical sample, the MoCA score showed good sensitivity for detecting amyloid pathology but with low specificity. Thus a total MoCA score of 28 is needed to confidently rule out risk for AD pathology.
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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 | 0.004 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".