The Montreal Cognitive Assessment: Normative Data from a Large, Population-Based Sample of Healthy Adults in China

BackgroundThe Montreal Cognitive Assessment (MoCA) is a valuable tool for detecting cognitive impairment, but its accuracy is significantly influenced by demographic and socio-cultural factors. Consequently, the development of appropriate normative values becomes particularly crucial in ensuring its reliable use and interpretation. ObjectiveGenerate MoCA normative values based on demographics for healthy chinese adults. MethodsThe assessment conducted in this study utilizes the MoCA scale, specifically employing the Mandarin-8.1 version (Chinese Mandarin version). Based on the geographical distribution of administrative regions in mainland china, this study recruited a total of 3,097 healthy individuals aged over 20 years. Drawing on insights from prior normative studies, we performed multiple linear regression analysis, incorporating age, gender, and education level as predictor variables, to examine their associations with the total score and sub-cognitive domains of MoCA. Subsequently, we established normative values and cut-off values stratified by age and education level. ResultsThe participants in this study (n=3,097) exhibit a balanced gender distribution, with an average age of 54.46 years (SD 14.38) and an average education period of 9.49 years (SD 4.61). The study population demonstrates an average MoCA score of 23.25 points (SD 4.82). The findings from the multiple linear regression analysis indicate that the total score of MoCA is influenced by age and education level, collectively accounting for 46.8% of the total variance. Higher age and lower education level are correlated with lower MoCA total scores. ConclusionThis study offers normative MoCA values specific to the Chinese population. Furthermore, the research findings indicate that a score of 26 may not represent the most optimal cut-off value. When assessing MoCA scores, it is imperative to comprehensively account for the participants age and educational background.