The Montreal Cognitive Assessment (MoCA) is one of the most common screening instruments for mild cognitive impairment. However, the standard MoCA is approximately two times longer to administer than the Mini-Mental State Examination. A total of 699 Czech and 175 American participants received the standard MoCA Czech and English versions and in the clinical part, a sample of 102 nondemented patients with Parkinson's disease (PD). We created a validated Czech short version (s-MoCA-CZ) from the original using item response theory. As expected, s-MoCA-CZ scores were highly correlated with the standard version (Pearson r = .94, p < .001). s-MoCA-CZ also had 80% classification accuracy in the differentiation of PD mild cognitive impairment from PD without impairment. The s-MoCA-CZ, a brief screening tool, is shorter to administer than the standard MoCA. It provides high-classification accuracy for PD mild cognitive impairment and is equivalent to that of the standard MoCA-CZ.

Department of Neurology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Neurology University of Pennsylvania School of Medicine Philadelphia PA

Department of Psychiatry University of Pennsylvania School of Medicine Philadelphia PA

National Institute of Mental Health Klecany Czech Republic

Parkinson's Disease and Mental Illness Research Education and Clinical Centers Philadelphia Veterans Affairs Medical Center Philadelphia PA

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Aarsland D, Andersen K, Larsen JP, Lolk A, & Kragh-Sorensen P (2003). Prevalence and characteristics of dementia in Parkinson disease: An 8-year prospective study. Archives of Neurology, 60, 387–392. PubMed

Aarsland D, Creese B, Politis M, Chaudhuri KR, Ffytche DH, Weintraub D, & Ballard C (2017). Cognitive decline in Parkinson disease. Nature Review Neurology, 13, 217–231. doi:10.1038/nrneurol.2017.27 PubMed DOI PMC

Aarsland D, Larsen JP, Karlsen K, Lim NG, & Tandberg, (1999). Mental symptoms in Parkinson’s disease are important contributors to caregiver distress. International Journal of Geriatric Psychiatry, 14, 866–874. PubMed

Benton AL, Hamsher K, & Sivan AB (1994). Multilingual Aphasia Examination (3rd ed.). San Antonio, TX: Psychological Corporation.

Bezdicek O, Libon DJ, Stepankova H, Panenkova E, Lukavsky J, Garrett KD, … Kopecek M (2014). Development, validity, and normative data study for the 12-word Philadelphia Verbal Learning Test [czP(r)VLT-12] among older and very old Czech adults. Clinical Neuropsychologist, 28, 1162–1181. doi:10.1080/13854046.2014.952666 PubMed DOI

Bezdicek O, Michalec J, Nikolai T, Stepankova H, Panenkova E, Harsa P, … Ruzicka E (2014). Validity of the Montreal Cognitive Assessment in the detection of Mild Cognitive Impairment in Parkinson’s disease. Ceska a Slovenska Neurologie a Neurochirurgie, 77, 47–53.

Bezdicek O, Moták L, Axelrod BN, Preiss M, Nikolai T, Vyhnálek M, … Růžička E (2012). Czech version of the Trail Making Test: Normative data and clinical utility. Archives of Clinical Neuropsychology, 27, 906–914. PubMed

Bezdicek O, Moták L, Schretlen DJ, Preiss M, Axelrod BN, Nikolai T, … Růžička E (2016). Sociocultural and language differences on the Trail Making Test. Archives of Assessment Psychology, 6, 33–48.

Bezdicek O, Nikolai T, Michalec J, Růžička F, Havránková P, Roth J, … Růžička E (2017). The diagnostic accuracy of Parkinson’s disease mild cognitive impairment battery using the Movement Disorder Society Task Force criteria. Movement Disorders Clinical Practice, 4, 237–244. doi:10.1002/mdc3.12391 PubMed DOI PMC

Bezdicek O, Stepankova H, Martinec Novakova L, & Kopecek M (2016). Toward the processing speed theory of activities of daily living in healthy aging: Normative data of the Functional Activities Questionnaire. Aging Clinical and Experimental Research, 28, 239–247. doi:10.1007/s40520-015-0413-5 PubMed DOI

Bezdicek O, Sulc Z, Nikolai T, Stepankova H, Kopecek M, Jech R, Ruzicka E (2017). A parsimonious scoring and normative calculator for the Parkinson’s disease mild cognitive impairment battery. The clinical Neuropsychologist, 1231–1247. doi:10.1080/13854046.2017.1293161 PubMed DOI

Brayne C, Fox C, & Boustani M (2007). Dementia screening in primary care: Is it time? Journal of the American Medical Association, 298, 2409–2411. doi:10.1001/jama.298.20.2409 PubMed DOI

Choi SW (2009). Firestar: Computerized adaptive testing simulation program for polytomous item response theory models. Applied Psychological Measurement, 33, 644–645. doi:10.1177/0146621608329892 DOI

Dalrymple-Alford JC, MacAskill MR, Nakas CT, Livingston L, Graham C, Crucian GP, … Anderson TJ (2010). The MoCA: Well-suited screen for cognitive impairment in Parkinson disease. Neurology, 75, 1717–1725. doi:10.1212/WNL.0b013e3181fc29c9 PubMed DOI

DeLong ER, DeLong DM, & Clarke-Pearson DL (1988). Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics, 44, 837–845. PubMed

Dirnberger G, & Jahanshahi M (2013). Executive dysfunction in Parkinson’s disease: A review. Journal of Neuropsychology, 7, 193–224. doi:10.1111/jnp.12028 PubMed DOI

Dorsey ER, Constantinescu R, Thompson JP, Biglan KM, Holloway RG, Kieburtz K, … Tanner CM (2007). Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology, 68, 384–386. doi:10.1212/01.wnl.0000247740.47667.03 PubMed DOI

Dubois B, Burn D, Goetz C, Aarsland D, Brown RG, Broe GA, … Emre M (2007). Diagnostic procedures for Parkinson’s disease dementia: Recommendations from the Movement Disorder Society Task Force. Movement Disorders, 22, 2314–2324. doi:10.1002/mds.21844 PubMed DOI

Embretson SE, & Reise SP (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum.

Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, … Lane R (2004). Rivastigmine for dementia associated with Parkinson’s disease. New England Journal of Medicine, 351, 2509–2518. doi:10.1056/NEJMoa041470 PubMed DOI

Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, … Dubois B (2007). Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Movement Disorders, 22, 1689–1707. doi:10.1002/mds.21507 PubMed DOI

Fawcett T (2006). An introduction to ROC analysis. Pattern Recognition Letters, 27, 861–874. doi:10.1016/j.patrec.2005.10.010 DOI

Fengler S, Kessler J, Timmermann L, Zapf A, Elben S, Wojtecki L, … Kalbe E (2016). Screening for cognitive impairment in Parkinson’s disease: Improving the diagnostic utility of the MoCA through subtest weighting. PLoS ONE, 11(7), e0159318. doi:10.1371/journal.pone.0159318 PubMed DOI PMC

Fernandez AL, & Marcopulos BA (2008). A comparison of normative data for the Trail Making Test from several countries: Equivalence of norms and considerations for interpretation. Scandinavian Journal of Psychology, 49, 239–246. doi:10.1111/j.1467-9450.2008.00637.x PubMed DOI

Florkowski CM (2008). Sensitivity, specificity, receiver-operating characteristic (ROC) curves and likelihood ratios: Communicating the performance of diagnostic tests. Clinical Biochemist. Reviews, 29(Suppl. 1), S83–S87. PubMed PMC

Folstein MF, Folstein SE, & McHugh PR (1975). “Minimental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. PubMed

Gill DJ, Freshman A, Blender JA, & Ravina B (2008). The Montreal Cognitive Assessment as a screening tool for cognitive impairment in Parkinson’s disease. Movement Disorders, 23, 1043–1046. doi:10.1002/mds.22017 PubMed DOI

Guttman L (1945). A basis for analyzing test-retest reliability. Psychometrika, 10, 255–282. PubMed

Henderson EJ, Chu H, Gaunt DM, Whone AL, Ben-Shlomo Y, & Lyell V (2016). Comparison of Test Your Memory and Montreal Cognitive Assessment measures in Parkinson’s disease. Parkinson’s Disease, 2016, 1012847. doi:10.1155/2016/1012847 PubMed DOI PMC

Hoops S, Nazem S, Siderowf AD, Duda JE, Xie SX, Stern MB, & Weintraub D (2009). Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology, 73, 1738–1745. doi:10.1212/WNL.0b013e3181c34b47 PubMed DOI PMC

Horton DK, Hynan LS, Lacritz LH, Rossetti HC, Weiner MF, & Cullum CM (2015). An abbreviated Montreal Cognitive Assessment (MoCA) for dementia screening. The Clinical Neuropsychologist, 29, 413–425. doi:10.1080/13854046.2015.1043349 PubMed DOI PMC

Hughes AJ, Daniel SE, Kilford L, & Lees AJ (1992). Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases. Journal of Neurology Neurosurgery & Psychiatry, 55, 181–184. PubMed PMC

Jankovic J (2008). Parkinson’s disease: Clinical features and diagnosis. Journal of Neurology Neurosurgery & Psychiatry, 79, 368–376. doi:10.1136/jnnp.2007.131045 PubMed DOI

Kopecek M, Bezdicek O, Sulc Z, Lukavsky J, & Stepankova H (2016). Montreal Cognitive Assessment and Mini-Mental State Examination reliable change indices in healthy older adults. International Journal of Geriatric Psychiatry, 32, 868–875. doi:10.1002/gps.4539 PubMed DOI

Kopecek M, Stepankova H, Lukavsky J, Ripova D, Nikolai T, & Bezdicek O (2017). Montreal Cognitive Assessment (MoCA): Normative data for old and very old Czech adults. Applied Neuropsychology: Adult, 24, 23–29. doi:10.1080/23279095.2015.1065261 PubMed DOI

Litvan I, Goldman JG, Troster AI, Schmand BA, Weintraub D, Petersen RC, … Emre M (2012). Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Movement Disorders, 27, 349–356. doi:10.1002/mds.24893 PubMed DOI PMC

Lord FM (1980). Applications of item response theory to practical testing problems. Hillsdale, NJ: Routledge.

Moore TM, Scott JC, Reise SP, Port AM, Jackson CT, Ruparel K, … Gur RC (2015). Development of an abbreviated form of the Penn Line Orientation Test using large samples and computerized adaptive test simulation. Psychological Assessment, 27, 955–964. doi:10.1037/pas0000102 PubMed DOI PMC

Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, … Chertkow H (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of American Geriatric Society, 53, 695–699. doi:10.1111/j.1532-5415.2005.53221.x PubMed DOI

Nazem S, Siderowf AD, Duda JE, Have TT, Colcher A, Horn SS, … Weintraub D (2009). Montreal Cognitive Assessment performance in patients with Parkinson’s disease with “normal” global cognition according to Mini-Mental State Examination score. Journal of American Geriatric Society, 57, 304–308. doi:10.1111/j.1532-5415.2008.02096.x PubMed DOI PMC

Nikolai T, Štěpánková H, Michalec J, Bezdíček O, Horáková K, Marková H, … Kopeček M (2015). Testy verbální fluence: Česká normativní studie pro osoby vyššího véku [Verbal fluency tests: Czech normative study for older persons]. Ceska a Slovenska Neurologie a Neurochirurgie, 78, 292–299.

Ostrosky-Solis F, Canseco E, Quintanar L, Navarro E, Meneses S, & Ardila A (1985). Sociocultural effects in neuropsychological assessment. International Journal of Neuroscience, 27, 53–66. PubMed

Owen AM, James M, Leigh PN, Summers BA, Marsden CD, Quinn NP, … Robbins TW (1992). Fronto-striatal cognitive deficits at different stages of Parkinson’s disease. Brain, 115, 1727–1751. PubMed

Panenková E, Kopeček M, & Lukavský J (2016). Item analysis and possibility to abbreviate the Montreal Cognitive Assessment. Czech and Slovak Psychiatry, 112, 63–69.

Pigott K, Rick J, Xie SX, Hurtig H, Chen-Plotkin A, Duda JE, … Weintraub D (2015). Longitudinal study of normal cognition in Parkinson disease. Neurology, 85, 1276–1282. doi:10.1212/wnl.0000000000002001 PubMed DOI PMC

Pirogovsky E, Schiehser DM, Obtera KM, Burke MM, Lessig SL, Song DD, … Filoteo JV(2014). Instrumental activities of daily living are impaired in Parkinson’s disease patients with mild cognitive impairment. Neuropsychology, 28, 229–237. doi:10.1037/neu0000045 PubMed DOI

Reban J (2006). Montrealský kognitivni test (MoCA): Přinos k diagnostice demence [Montreal Cognitive Assessment (MoCA): Contribution to diagnosis of predementia]. česká Geriatrická Revue, 4, 224–229.

Roalf DR, Moberg PJ, Xie SX, Wolk DA, Moelter ST, & Arnold SE (2013). Comparative accuracies of two common screening instruments for classification of Alzheimer’s disease, mild cognitive impairment, and healthy aging. Alzheimer’s & Dementia, 9, 529–537. doi:10.1016/j.jalz.2012.10.001 PubMed DOI PMC

Roalf DR, Moore TM, Mechanic-Hamilton D, Wolk DA, Arnold SE, Weintraub DA, & Moberg PJ (2017). Bridging cognitive screening tests in neurologic disorders: A crosswalk between the short Montreal Cognitive Assessment and Mini-Mental State Examination. Alzheimer’s & Dementia, 13, 947–952. doi:10.1016/j.jalz.2017.01.015 PubMed DOI PMC

Roalf DR, Moore TM, Wolk DA, Arnold SE, Mechanic-Hamilton D, Rick J, … Moberg PJ (2016). Defining and validating a short form Montreal Cognitive Assessment (s-MoCA) for use in neurodegenerative disease. Journal of Neurology Neurosurgery & Psychiatry, 87, 1303–1310. doi:10.1136/jnnp-2015-312723 PubMed DOI PMC

Rossetti HC, Lacritz LH, Cullum CM, & Weiner MF (2011). Normative data for the Montreal Cognitive Assessment (MoCA) in a population-based sample. Neurology, 77, 1272–1275. doi:10.1212/WNL.0b013e318230208a PubMed DOI

Samejima F (1969). Estimation of latent ability using a response pattern of graded scores. Psychometrika, 34(4 pt. 2), 100.

Schrag A, Jahanshahi M, & Quinn N (2000). What contributes to quality of life in patients with Parkinson’s disease? Journal of Neurology Neurosurgery & Psychiatry, 69, 308–312. PubMed PMC

Solomon SR, & Sawilowsky SS (2009). Impact of rank-based normalizing transformations on the accuracy of test scores. Journal of Modern Applied Statistical Methods, 8, 448–462.

Steinhaus H (1956). Sur la division des corps materiéls en parties [On the division of material elements in parts]. Bulletin of the Polish Academy of Sciences, 4, 801–804.

Stepankova H, Nikolai T, Lukavsky J, Bezdicek O, Vrajova M, & Kopecek M (2015). Mini-Mental State Examination: Czech Normative Study. Ceska a Slovenska Neurologie a Neurochirurgie, 78, 57–63.

Testa SM, Winicki JM, Pearlson GD, Gordon B, & Schretlen DJ (2009). Accounting for estimated IQ in neuropsychological test performance with regression-based techniques. Journal of the International Neuropsychological Society, 15, 1012–1022. PubMed

van de Vijver F, & Tanzer N (2004). Bias and equivalence in cross-cultural assessment: An overview. Revue Européenne de Psychologie Appliquée, 2, 119–135.

Vossius C, Larsen JP, Janvin C, & Aarsland D (2011). The economic impact of cognitive impairment in Parkinson’s disease. Movement Disorders, 26, 1541–1544. doi:10.1002/mds.23661 PubMed DOI

Wainer H, Dorans NJ, Eignor D, Flaugher R, Green BF, Mislevy RJ, … Thissen D (2000). Computerized adaptive testing: A primer (2nd ed.). New York, NY: Routledge.

Williams-Gray CH, Foltynie T, Brayne CE, Robbins TW, & Barker RA (2007). Evolution of cognitive dysfunction in an incident Parkinson’s disease cohort. Brain, 130, 1787–1798. doi:10.1093/brain/awm111 PubMed DOI

Williams-Gray CH, Mason SL, Evans JR, Foltynie T, Brayne C, Robbins TW, & Barker RA (2013). The CamPaIGN study of Parkinson’s disease: 10-Year outlook in an incident population-based cohort. Journal of Neurology Neurosurgery & Psychiatry, 84, 1258–1264. doi: 10.1136/jnnp-2013-305277 PubMed DOI

Zadikoff C, Fox SH, Tang-Wai DF, Thomsen T, de Bie RM, Wadia P, … Marras C (2008). A comparison of the mini-mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Movement Disorders, 23, 297–299. doi:10.1002/mds.21837 PubMed DOI

Automated analysis of spoken language differentiates multiple system atrophy from Parkinson's disease