Assessment of the Turkish Version of the MMSE, MoCA, and ACE-R for Screening Mild Vascular Cognitive Impairment
TL;DR
It is demonstrated that the ACE-R is the most accurate screening tool for detecting mild vascular cognitive impairment, with the MoCA trailing by a very small margin, while the MMSE may be less sensitive in the early stages.
Abstract
Aim: Vascular cognitive impairment (VCI), which affects many people, is important to distinguish from other types of cognitive impairment because vascular risk factors can slow disease onset and progression. In our study, we aimed to determine the most appropriate cognitive screening tool for vascular cognitive impairment. Methods: This study included 110 patients with mild VCI and a control group of 90 volunteers aged over 55 and was conducted between July 2024 and September 2025. Mild VCI was diagnosed according to DSM-5 criteria. We administered the Montreal Cognitive Assessment (MoCA), the Standardized Mini-Mental State Examination (MMSE), and Addenbrooke’s Cognitive Examination Test (ACE-R) to all participants. Results: Our findings demonstrate that all three screening tools significantly differentiate patients with mild VCI from healthy controls. ACE-R had the highest area under the curve (AUC = 0.967) and showed 90% sensitivity and 100% specificity at a cut-off of 68.5. MoCA also showed relatively high sensitivity (86.4%) and specificity (91.1%), with high diagnostic accuracy (AUC = 0.946). In contrast, the MMSE showed a slightly lower diagnostic performance (AUC = 0.926) but still had high specificity (92.2%). Conclusions: Our study demonstrates that the ACE-R is the most accurate screening tool for detecting mild vascular cognitive impairment, with the MoCA trailing by a very small margin, while the MMSE may be less sensitive in the early stages. Given the administration time, the MoCA can be a quicker alternative to the ACE-R.