Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI: Validity and utility in elderly Japanese

Kuniaki Otsuka, Yutaka Kubo, Gaku Yamanaka, Junko Sasaki, Tomoko Kikuchi, Toshie Saito, Germaine Cornelissen, Bunpei Uno

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Objectives: To develop a 20-minute cognitive screening tool of touch-panel type (Tokyo Cognitive Assessment for MCI, ToCA-MCI) to assist paramedical staff and first-line physicians in detecting mild cognitive impairment (MCI), a clinical state that often progresses to dementia, and to assess the reliability and validity of the ToCA-MCI in elderly Japanese subjects. Participants: Subjects were recruited from community-based medical health checks in 2015 and 2016. The ToCA-MCI, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), the Clock Drawing Test (CDT), the Clinical Dementia Rating (CDR) scale, and routine neurophysiological examinations were conducted on 105 elderly subjects. Mild Alzheimer's disease (AD) was found in 5 and MCI in 21 subjects. Among the 79 controls, age-associated cognitive impairment (AACI) affected 22. Measurements: The ToCA-MCI was administered to all participants. Sensitivity and specificity of the ToCA-MCI in detecting MCI were assessed. Results: The ToCA-MCI score was highly correlated with the MMSE (r=0.664, p< 0.0001), HDS-R (r=0.538, p<0.0001), CDT (r=0.437,/p<0.0001), and CDR (r= -0.442, p< 0.0001) scores. The area under the receiver-operator curve (AUC) for predicting MCI by the ToCA-MCI was 0.9581(odds ratio=60.9). Using a cut-off point of 17/18, the ToCA-MCI demonstrated a sensitivity of 92.3% and a specificity of 83.5% in diagnosing MCI. Conclusion: MCI is an evolving and somewhat controversial clinical entity. The ToCA-MCI is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE. The ToCA-MCI could be a useful cognitive test for screening for MCI. It could be recommended for geriatric health screening in the community as a multi-player participation-type screening tool, and for the early detection of MCI in a primary clinical setting.

Original languageEnglish (US)
Pages (from-to)579-621
Number of pages43
JournalTherapeutic Research
Issue number6
StatePublished - 2017


  • Cognitive screening tool
  • Mild cognitive impairment
  • Multi-player participation-type
  • ToCA-MCI
  • Touch-panel type


Dive into the research topics of 'Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI: Validity and utility in elderly Japanese'. Together they form a unique fingerprint.

Cite this