Journal of Neural Transmission

, Volume 123, Issue 4, pp 431–438 | Cite as

MMSE and MoCA in Parkinson’s disease and dementia with Lewy bodies: a multicenter 1-year follow-up study

  • Roberta BiundoEmail author
  • L. Weis
  • S. Bostantjopoulou
  • E. Stefanova
  • C. Falup-Pecurariu
  • M. G. Kramberger
  • G. J. Geurtsen
  • A. Antonini
  • D. Weintraub
  • D. Aarsland
Neurology and Preclinical Neurological Studies - Original Article


The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to test cognitive impairment in Lewy body disease (LBD), but there is no consensus on which is best suited to assess cognition in clinical practice and most sensitive to cognitive decline. Retrospective cohort study of 265 LBD patients [Parkinson’s disease (PD) without dementia (PDnD, N = 197), PD with dementia (PDD, N = 40), and dementia with Lewy bodies (DLB, N = 28)] from an international consortium who completed both the MMSE and MoCA at baseline and 1-year follow-up (N = 153). Percentage of relative standard deviation (RSD%) at baseline was the measure of inter-individual variance, and estimation of change (Cohen’s d) over time was calculated. RSD% for the MoCA (21 %) was greater than for the MMSE (13 %) (p = 0.03) in the whole group. This difference was significant only in PDnD (11 vs. 5 %, p < 0.01), but not in PDD (30 vs. 19 %, p = 0.37) or DLB (15 vs. 14 %, p = 0.78). In contrast, the 1-year estimation of change did not differ between the two tests in any of the groups (Cohen’s effect <0.20 in each group). MMSE and MoCA are equal in measuring the rate of cognitive changes over time in LBD. However, in PDnD, the MoCA is a better measure of cognitive status as it lacks both ceiling and floor effects.


Parkinson disease MMSE MoCA Dementia with Lewy bodies Rate of cognitive decline 



We are thankful to Pablo Martinez-Martin for helping with statistical analysis

Compliance with ethical standards

All authors gave final approval of this version of the manuscript to be published. We can assure that there is no one else who fulfils the criteria but has not been included as an author.


This working group is funded by the Research Council of Norway, Norway under the aegis of JPND.

Conflict of interest

The authors have no competing interest to declare.

Supplementary material

702_2016_1517_MOESM1_ESM.doc (169 kb)
Supplementary material 1 (DOC 169 kb)


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Roberta Biundo
    • 1
    Email author
  • L. Weis
    • 1
  • S. Bostantjopoulou
    • 2
  • E. Stefanova
    • 3
  • C. Falup-Pecurariu
    • 4
  • M. G. Kramberger
    • 5
  • G. J. Geurtsen
    • 6
  • A. Antonini
    • 1
  • D. Weintraub
    • 7
  • D. Aarsland
    • 8
    • 9
  1. 1.Parkinson’s Disease and Movement Disorders Unit“Fondazione Ospedale San Camillo” - I.R.C.C.S.Venice-LidoItaly
  2. 2.3rd Department of NeurologyAristotle University of ThessalonikiThessaloníkiGreece
  3. 3.Clinic of Neurology CCS, School of MedicineUniversity of BelgradeBelgradeSerbia
  4. 4.Department of Neurology, Faculty of Medicine, County Emergency Clinic HospitalTransilvania UniversityBrasovRomania
  5. 5.Department of NeurologyUniversity Medical Center LjubljanaLjubljanaSlovenia
  6. 6.Department of Medical PsychologyAcademic Medical HospitalAmsterdamThe Netherlands
  7. 7.Department of PsychiatryUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  8. 8.Department of NVS, Center for Alzheimer ResearchKarolinska InstituteStockholmSweden
  9. 9.Centre for Age-Related MedicineStavanger University HospitalStavangerNorway

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