Normative study of the Taiwanese version of the Montreal Cognitive Assessment (MoCA) in community-dwelling individuals in Taiwan

Yu-Hsiang Cheng; Shih-Chieh Lee; Yen-Ching Chen; Jen-Hau Chen; Rwei-Ling Yu; Wei-Ju Lee; Jung-Lung Hsu; Cheng-Sheng Chen; Jong-Ling Fuh

doi:10.1097/JCMA.0000000000001265

Normative study of the Taiwanese version of the Montreal Cognitive Assessment (MoCA) in community-dwelling individuals in Taiwan

J Chin Med Assoc. 2025 Jul 8. doi: 10.1097/JCMA.0000000000001265. Online ahead of print.

Authors

Yu-Hsiang Cheng¹, Shih-Chieh Lee^{2

3}, Yen-Ching Chen^{4

5}, Jen-Hau Chen⁶, Rwei-Ling Yu^{7

8}, Wei-Ju Lee^{9

10}, Jung-Lung Hsu¹¹, Cheng-Sheng Chen^{12

13}, Jong-Ling Fuh^{1

14

15}

Affiliations

¹ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
² School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
³ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan, ROC.
⁴ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC.
⁵ Master Program of Statistics, National Taiwan University, Taipei, Taiwan, ROC.
⁶ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
⁷ Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.
⁸ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.
⁹ Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
¹⁰ School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan, ROC.
¹¹ Department of Neurology, New Taipei Municipal Tu Cheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei City, Taiwan, ROC.
¹² Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
¹³ College of Medicine, Kaohsiung Medical University, Kaohsiung Taiwan, ROC.
¹⁴ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
¹⁵ Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.

PMID: 40626349
DOI: 10.1097/JCMA.0000000000001265

Abstract

Background: The Montreal Cognitive Assessment (MoCA) may not be appropriately interpreted in Taiwan because of the lack of large-scale normative data. Moreover, examinees' demographic characteristics may influence their MoCA scores. However, previous studies have not adequately adjusted for these effects. This study aimed to use regression-based methods to establish demographically adjusted MoCA norms.

Methods: Participants were recruited from six hospitals and neighboring communities from all geographic areas of Taiwan. Multiple regression analyses were conducted to quantify the effects of age, education, and sex on MoCA total and domain scores, resulting in correction equations and adjusted cutoff scores.

Results: A total of 2,310 cognitively healthy participants were included in the analysis. Age and education significantly affected the total and all domain scores. Sex affected naming, language, and abstract thinking domain scores. Correction equations and corresponding cutoffs were proposed for MoCA total and domain scores to support more precise clinical interpretations.

Conclusion: This study provides regression-adjusted norms for the MoCA, improving its accuracy and clinical utility in Taiwan. An adjusted total MoCA score of 23 points is recommended as the cutoff for identifying potential cognitive impairment, with domain-specific cutoffs further supporting individualized interpretation.

Keywords: Comprehensive cognitive abilities; Demographic variables; Montreal Cognitive Assessment; Neuropsychological assessment; Normative data..