Evaluación de funcionamiento cognitivo en el adulto mayor: Análisis y contrastación de los tres instrumentos más usados en Chile (MMSE, MoCA, y ACE-R)

Resumen

Background: Several instruments are available to measure cognitive functioning in older adults. However, there is paucity of information about their factorial structure and psychometric properties. Aim: To determine the factorial structure and the internal reliability of the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) and the Adenbrookke´s Cognitive Examination (ACE-R), and their cognitive impairment detection capabilities. Material and methods: MMSE, MoCA and ACE-R were applied to 203 older adults aged 54 to 88 years (77% women), excluding participants with dementia. Results: The factorial structure of the MMSE suggested that items referred to memory process should be eliminated due to their low reliability and factor loading (ß = 0.12; p =0.146). Although the MoCA had a good reliability, object denomination process items also had to be dropped (ß = 0.22; p = 0.003). The ACE-R demonstrated a single factorial structure for all cognitive processes and had a good internal consistency. MMSE, MoCA and ACE-R classified as having dementia 5, 27 and 42% of participants, respectively. Conclusions: MoCA and the ACE-R scales appear as better instruments to detect dementia in older people.