The Craft Story 21 is a paragraph story recall test that replaced the Logical Memory subtest of the Wechsler Memory Scale-Revised 9 used in prior versions of the UDS. The MoCA-MIS score is part of MoCA version 8.1 and maybe downloaded from We also considered two alternative scoring methods, one based on free recall data alone (3 points per correct word), and a second based on the sum of the free (3 points per word) and the category-cued, semantic (2 points per word) recall performance. The MoCA-MIS 6 includes points for the free recall condition and the cued conditions (3 points for each word on free recall, 2 for each on category-cued recall, 1 for each on multiple-choice recall). Only the points earned in the delayed free recall condition of the memory section (1 point per correct word) are added to the MoCA total score. This is followed by a category-cued semantic recall condition, and, finally, a multiple choice-cued recall from presentation of the correct item paired with two items within the same category but not on the list. The delay is variable, but estimated at five minutes followed by free recall of the 5-word list. The memory section provides two trials to learn a word list of five nouns followed by a delay in which subjects are asked additional questions from other sections of the MoCA (i.e., attention, sentence repetition, letter fluency, similarities). The Montreal Cognitive Assessment 5 is a screening instrument composed of eight sections including visuospatial/executive, naming, memory, attention, language, abstraction, delayed recall, and orientation. The San Diego State University IRB waived the requirement for a formal proposal due to non-human interaction and use of de-identified data. Research use of the NACC database was approved by the University of Washington IRB. Each ADC had individual Institutional Review Board (IRB) approval and written informed consent was obtained for each participant. Amnestic MCI (aMCI) is defined as MCI with impairment in memory alone (single domain) or impairment in memory and at least one other area of cognition (multi-domain). 1 Finally, the diagnosis requires objective identification of at least one area of cognitive impairment. In addition, a diagnosis of MCI requires relatively preserved basic activities of daily living and no more than mild functional impairment on complex tasks. In this study, we investigate whether the MoCA-MIS performs comparably to delayed paragraph recall for differentiating aMCI from normal cognition using a large sample of subjects carefully characterized by Alzheimer’s Disease Centers (ADCs) that contribute to the National Alzheimer’s Coordinating Center (NACC) database.ĭiagnoses of MCI were based on the presence of concern about a change in cognition obtained from the subject or informant, or indication of a change in performance on longitudinal neuropsychological testing. 6 The MoCA-MIS may be a useful tool for differentiating amnestic MCI (aMCI) from normal cognition in older adults. The word list recall task embedded in the Memory section of the Montreal Cognitive Assessment (MoCA) 5 allows calculation of a Memory Index Score (MoCA-MIS) which includes free and cued recall and is typically affected early in neuropathological changes associated with AD. 4 The study also found that word-list recall was significantly associated with hippocampal volume while story memory was not. A study comparing story and word list recall in subjects with aMCI found that a word-list recall task performed better than story recall in discriminating subjects with high versus low levels of the amyloid-β PET biomarker indication of a pre-clinical Alzheimer’s neurodegenerative process. Delayed paragraph recall tasks are commonly used for this purpose, but word list recall tasks are also used. 3 Therefore, a sensitive measure of delayed recall is an especially important component of neuropsychological assessment. A deficit in episodic memory assessed by delayed recall of new information is the most common domain of cognitive function which triggers a diagnosis of MCI. 2 Professionals in a general practice setting and those investigating Alzheimer's disease (AD) in clinical trials and cohort studies often require identification of individuals in early stages of disease. 1 These individuals are at high risk for progression to clinical dementia. Mild Cognitive Impairment (MCI) describes individuals for whom functional capacity is relatively intact, but who, on objective testing, show cognitive decline in at least one area of neuropsychological functioning.
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