Table 4.

Optimal MoCA cutoffs to distinguish between MCI and dementia by race/ethnicity and education level, among study participants with MCI or dementia (DM); MoCA scores range from 0 to 30 and lower scores signify more impairment (n = 2009)

Years of education	Number of participants	Cutoff (95% CI)∗	Sensitivity (%)	Specificity (%)	AUC (95% CI)
Non-Hispanic Whites	n = 1676; 83.4%
Overall	MCI = 733; DM = 943	≤19 [≤18, ≤20]	70.31	83.06	0.844 [0.826, 0.861]
≤12†	MCI = 97; DM = 191	≤17 [≤14, ≤18]	70.16	80.41	0.840 [0.793, 0.881]
13–16	MCI = 315; DM = 434	≤19 [≤15, ≤20]	72.12	81.27	0.844 [0.816, 0.869]
>16	MCI = 321; DM = 318	≤20 [≤19, ≤22]	68.24	84.37	0.838 [0.807, 0.866]
Non-Hispanic Blacks	n = 241; 12.0%
Overall	MCI = 158; DM = 83	≤16 [≤15, ≤17]	78.31	88.61	0.898 [0.853, 0.933]
≤12†	MCI = 50; DM = 36	≤13 [≤12, ≤15]	77.78	96.00	0.919 [0.839, 0.967]
13–16	MCI = 71; DM = 27	≤17 [≤16, ≤19]	77.78	92.96	0.870 [0.787, 0.930]
>16	MCI = 37; DM = 20	≤19 [≤15, ≤20]	90.00	83.78	0.944 [0.849, 0.987]
Hispanics	n = 92; 4.6%
Overall	MCI = 45; DM = 47	≤16 [≤15, ≤19]	72.34	97.78	0.886 [0.803, 0.943]
≤12†	MCI = 12; DM = 22	≤15 [≤14, ≤15]	90.91	100.00	0.966 [0.839, 0.999]
13–16	MCI = 18; DM = 16	≤16 [≤13, ≤16]	75.00	100.00	0.858 [0.695, 0.953]
>16	MCI = 15; DM = 9	≤19 [≤12, ≤26]	77.78	73.33	0.726 [0.507, 0.886]

Abbreviations: AUC, areas under the ROC curve; CI, confidence interval; MCI, mild cognitive impairment; MoCA, Montreal Cognitive Assessment.

^∗Bootstrap confidence interval (100,000 iterations; random number seed: 978).

^†MoCA scoring rules adjust for ≤12 years of education, adding one point to the total score of individuals with ≤12 years of education.