In this sense, a cutoff score essentially creates a classification system for the test participants. When applied to screening for MCI, a cutoff score indicates that participants above the cutoff score are classified as having normal cognition, and those below the cutoff score are considered cognitively impaired. Such inconsistency and contingency cast doubt on whether seeking a single cutoff score is an accomplishable goal and whether an alternative procedure might shed new light on any cutoffs.Ī cutoff score has been typically determined according to the result of another gold standard validating criterion, which vary across studies. These studies suggested that the cutoffs were contingent upon sampling (i.e., normative versus clinical), age, education, cultural background, and validating criteria. Recent studies in mainland China suggested that the cutoffs for MCI were 24 in a clinical sample and ranged from 18 to 25 in normative samples. Unfortunately, only 86% cases could be correctly identified as either normal or MCI. A recent meta-analysis of studies with strictly verifiable criteria of MCI suggested that the optimal cutoff was 23 based on balanced sensitivity (the probability of true positives) and specificity (the probability of true negatives) as well as samples of different language, cultural, and educational background. Nevertheless, different from the original cutoff score of 24, various cutoffs have been identified, ranging from 18/19 to 26/27 across different cultures. The optimal cutoff score for screening mild cognitive impairment (MCI) in older adults has been widely explored in applying the Montreal Cognitive Assessment (MoCA), which is a tool designed exclusively for screening MCI in older adults.
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