12, 13, 16, 17, 18 According to data from the Ministry of Health and Welfare, only 17.2% of older Koreans in 2008 and 34% in 2020 have had a high school or higher education. Indeed, studies conducted in Western countries using the MoCA and MMSE have shown that participants have an average of 14–15 years of education, 9, 14, 15 while studies conducted in Korea show an average education level of 5–8 years. In other words, since the MoCA includes difficult items that elderly individuals with low educational attainment cannot perform well, it can be predicted that if the MoCA is conducted for elderly people with low educational attainment, it will not be different from the discriminability of the MMSE, which consists of relatively easy items. The researchers suggested that this was because the level of education of the elderly in Korea was lower than that of the elderly who participated in foreign studies. However, another domestic study 13 did not find a significant difference in discriminating vascular MCI from normal elderly individuals between the MoCA and MMSE. 10, 11Ī domestic study 12 also reported that the MoCA was more useful than MMSE in discriminating between normal elderly and amnestic MCI. 3, 4 Many studies have reported that the MoCA is superior to the MMSE in detecting MCI 5, 6, 7, 8, 9 and vascular cognitive impairment. It includes more subtests for assessing frontal and executive function than the Mini-Mental State Examination (MMSE). 2 It is one of the representative screening tests used in clinical settings. The Montreal Cognitive Assessment (MoCA) 1 was developed as a screening test for mild cognitive impairment (MCI).
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