{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:17:03Z","timestamp":1777393023851,"version":"3.51.4"},"reference-count":77,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2024,8,27]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the era of disease-modifying therapies, empowering the clinical neuropsychologist\u2019s toolkit for timely identification of mild cognitive impairment (MCI) is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Here we examine the clinimetric properties of the Montreal Cognitive Assessment (MoCA) for the early diagnosis of MCI due to Alzheimer\u2019s disease (MCI-AD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data from 48 patients with MCI-AD and 47 healthy controls were retrospectively analyzed. Raw MoCA scores were corrected according to the conventional Nasreddine\u2019s 1-point correction and demographic adjustments derived from three normative studies. Optimal cutoffs were determined while previously established cutoffs were diagnostically reevaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The original Nasreddine\u2019s cutoff of 26 and normative cutoffs (non-parametric outer tolerance limit on the 5th percentile of demographically-adjusted score distributions) were overly imbalanced in terms of Sensitivity (Se) and Specificity (Sp). The optimal cutoff for Nasreddine\u2019s adjustment showed adequate clinimetric properties (\u226423.50, Se\u200a=\u200a0.75, Sp\u200a=\u200a0.70). However, the optimal cutoff for Santangelo\u2019s adjustment (\u226422.85, Se\u200a=\u200a0.65, Sp\u200a=\u200a0.87) proved to be the most effective for both screening and diagnostic purposes according to Larner\u2019s metrics. The results of post-probability analyses revealed that an individual testing positive using Santangelo\u2019s adjustment combined with a cutoff of 22.85 would have 84% post-test probability of receiving a diagnosis of MCI-AD (LR+\u200a=\u200a5.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We found a common (mal)practice of bypassing the applicability of normative cutoffs in diagnosis-oriented clinical practice. In this study, we identified optimal cutoffs for MoCA to be allocated in secondary care settings for supporting MCI-AD diagnosis. Methodological and psychometric issues are discussed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/jad-240339","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T11:50:55Z","timestamp":1723809055000},"page":"293-308","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["On the Clinimetrics of the Montreal Cognitive Assessment: Cutoff Analysis in Patients with Mild Cognitive Impairment due to Alzheimer\u2019s Disease"],"prefix":"10.1177","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4328-4739","authenticated-orcid":false,"given":"Ciro Rosario","family":"Ilardi","sequence":"first","affiliation":[{"name":"IRCCS SYNLAB SDN, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Menichelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, Rehabilitation Unit, Trieste University Hospital-ASUGI, University of Trieste, Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Michelutti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, Clinical Unit of Neurology, Trieste University Hospital-ASUGI, University of Trieste, Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana","family":"Cattaruzza","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, Clinical Unit of Neurology, Trieste University Hospital-ASUGI, University of Trieste, Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Federico","sequence":"additional","affiliation":[{"name":"IRCCS SYNLAB SDN, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Salvatore","sequence":"additional","affiliation":[{"name":"IRCCS SYNLAB SDN, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Iavarone","sequence":"additional","affiliation":[{"name":"Neurological Unit, CTO Hospital, AORN \u2018Ospedali dei Colli\u2019, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Manganotti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, Clinical Unit of Neurology, Trieste University Hospital-ASUGI, University of Trieste, Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13016"},{"key":"ref002","unstructured":"World Health Organization. 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