To the Editor: Older adults with mild cognitive impairment (MCI) are a heterogeneous group. Identification of MCI is clinically based, and diagnosis is not restricted to individuals only with memory problems, because impairments in other cognitive domains, in isolation or in conjunction with memory impairment, are recognized. This heterogeneity has led to an algorithm to categorize individuals with MCI into four subtypes: a major subdivision on amnestic and nonamnestic status followed by further subclassification into single- and multiple-domain categories. Subcategori-zation of MCI has important implications for research, prognosis, and potential early treatment, although MCI subcategorization is difficult to implement based only on clinical judgment, and a complete neuropsychological assessment is not always available. Therefore, a need exists for a simple methodology based on tests commonly used in clinical practice. Since its description, the Montreal Cognitive Assessment (MoCA) test has become a valuable tool in the detection of people with MCI. It was designed to address some of the limitations of the Mini-Mental State Examination (MMSE) because it assesses a broader range of cognitive domains and with more detail. Differences across MoCA cognitive domains have been reported in people with Parkinson's disease with and without cognitive impairment. This has not been explored in people with MCI. It was postulated that the MoCA may provide sufficient information in scoring different cognitive domains to assist in MCI subcategorization.
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