Education level, gender, and ethnicity are other moderating factors in cognitive tests. In this complicated environment, screening for dementia disease becomes challenging. Each of these factors, or a combination of them, may lead to permanent or temporary cognitive decline. 4 Disease comorbidity in addition to increased age may influence MMSE and MoCA scores to varying degrees, and since the cognitive decline is a natural part of aging, the effects of age become more influential on test scores over time. Also, patients with dementia often have comorbid diagnoses, such as depression, which may or may not be secondary to dementia. Depression and anxiety are prevalent and have a high rate of comorbidity, 3 while other common patient groups include schizophrenia and dementia. The population referred to an inpatient psychiatric clinic for the elderly are generally older than 65 years of age and include a diverse patient population and several diagnostic groups. Low scores on MoCA and MMSE do not necessarily indicate cognitive decline as individuals with chronically lower cognitive abilities, for example, intellectual developmental disorder, may naturally have a low score. One or both tests are typically included in the screening battery for incoming patients in psychiatric clinics for the elderly, used to direct further cognitive assessment. ![]() The Mini-Mental State Examination (MMSE) 1 and the Montreal Cognitive Assessment (MoCA) 2 are two commonly used screening tests for cognitive deficits. ![]() Since there are several cognitive functional areas, screening tests need to cover all cognitive areas and be sensitive enough to indicate cognitive decline even though only a single cognitive area has been affected. Screening tests are useful in detecting suspected cognitive decline.
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