Linking Cognitive Screening Tests in Community-Dwelling Older Adults: Crosswalk between the Montreal Cognitive Assessment-Basic and the Mini-Mental State Examination

J Am Med Dir Assoc. 2025 May;26(5):105550. doi: 10.1016/j.jamda.2025.105550. Epub 2025 Mar 27.

Abstract

Objective: To develop the crosswalk between the Montreal Cognitive Assessment-Basic (MoCA-B) and Mini-Mental Status Examination (MMSE) based on a community-dwelling older population to facilitate data synthesis and comparison.

Design: A cross-sectional study.

Setting and participants: We used baseline data of 2170 subjects with total MoCA-B and MMSE scores from an ongoing prospective cohort study, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE).

Methods: The MoCA-B and MMSE were administered by trained assessors. Equipercentile equating was used to develop the conversion table between MoCA-B and MMSE scores in the total sample and subgroups by age, sex, residency, and education level. The mean absolute error (MAE), intraclass correlation coefficient (ICC), and Bland-Altman plot were used to evaluate the linking performance.

Results: MoCA-B and MMSE scores converted bi-directionally for the overall sample and subgroups, with small standardized MAE (SMAE) and high ICC. The linking results between MoCA-B and MMSE scores were consistent across the total sample and the age and sex subgroups, while a 2-score difference was observed within the residency and education subgroups.

Conclusions and implications: This study provides easy-to-use crosswalks between measures of MoCA-B and MMSE with precision among community-dwelling older adults. Our results help to compare and pool data across studies using either of the 2 cognitive screening tests and provide a useful reference to clinicians for better evidence-based practice in patients evaluated using different cognitive tests.

Keywords: MMSE; MoCA-Basic; cognitive impairment; conversion; equipercentile equating.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Geriatric Assessment* / methods
  • Humans
  • Independent Living
  • Male
  • Mental Status and Dementia Tests*
  • Prospective Studies