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. 2020 Apr-Jun;14(2):145-152.
doi: 10.1590/1980-57642020dn14-020007.

Validation of the Argentine version of the Montreal Cognitive Assessment Test (MOCA): A screening tool for Mild Cognitive Impairment and Mild Dementia in Elderly

Cecilia M Serrano  1   2 , Marcos Sorbara  1 , Alexander Minond  3 , John B Finlay  4 , Raul L Arizaga  1 , Monica Iturry  5 , Patricia Martinez  1 , Gabriela Heinemann  1 , Celina Gagliardi  1 , Andrea Serra  1 , Florencia Ces Magliano  1 , Darío Yacovino  1   2 , María Martha Esnaola Y Rojas  1 , Adelaida Susana Ruiz  3 , Héctor Gastón Graviotto  1
Affiliations

Validation of the Argentine version of the Montreal Cognitive Assessment Test (MOCA): A screening tool for Mild Cognitive Impairment and Mild Dementia in Elderly

Cecilia M Serrano et al. Dement Neuropsychol. 2020 Apr-Jun.

Abstract
in English, Portuguese

The MoCA is a brief useful test to diagnose mild cognitive impairment (MCI) and mild dementia (MD). To date, no Argentine cross-cultural adapted validations of the Spanish version have been reported.

Objective: To validate the MoCA in the elderly and study its usefulness in MCI and MD.

Methods: This study included 399 individuals over 60 years old evaluated in the Cognitive-Behavioral Department (2017-2018). Patients with<3 years of education, sensory disturbances, psychiatric disorders, or moderate-severe dementia were excluded. The control group comprised cognitively normal subjects. Participants were classified according to neuropsychological assessment and clinical standard criteria into Control, MCI or MD groups. A locally adapted MoCA (MOCA-A) was administered to the patients and controls.

Results: Mean educational level was 10.34 years (SD 3.5 years). MoCA-A score differed significantly among groups (p<0.0001). MoCA-A performance correlated with educational level (r: 0.406 p<0.00001). Adopting a cut-off score ≥25 (YI=0.55), the sensitivity for MCI was 84.8% and for MD ​​100%, with specificity of 69.7%. When adding a single point to the score in patients with ≤12 years of education, the specificity of the test reached 81%.

Conclusion: The MoCA-A is an accurate reliable screening test for MCI and MD in Argentina.

O MoCA é um teste breve e útil para diagnosticar comprometimento cognitivo leve (CCL) e demência leve. Até o momento, nenhuma validação argentina com adaptação transcultural da versão em espanhol havia sido relatada.

Objetivo: Validar o MoCA em idosos e estudar sua utilidade no CCL e demência leve.

Métodos: Este estudo incluiu 399 indivíduos acima de 60 anos avaliados no departamento cognitivo-comportamental (2017-2018). Foram excluídos pacientes com menos de 3 anos de escolaridade, com distúrbios sensoriais, distúrbios psiquiátricos e demência moderada a grave. O grupo controle foi cognitivamente normal. Eles foram classificados de acordo com a avaliação neuropsicológica e os critérios clínicos padrão em Controles, MCI e demência leve. A versão adaptada do MoCA (MOCA-A) foi administrado aos pacientes e controles.

Resultados: Média de escolaridade: 10,34 anos (DP: 3,5). O escore MoCA-A foi significativamente diferente entre os grupos (p<0,0001). O MoCA-A correlacionou-se com a escolaridade (r=0,406 p<0,00001). Com uma pontuação de corte ≥25 (IY=0,55), a sensibilidade para CCL foi de 84,8% e para demência leve 100%, com especificidade de 69,7%. Adicionando um ponto único à pontuação em pacientes com menos de 12 anos de escolaridade, a especificidade do teste atingiu 81%.

Conclusão: O MoCA-A é um teste de rastreamento preciso e confiável para MCI e demência leve na Argentina.

Keywords: Alzheimer’s disease; cognitive dysfunction; dementia; mental status and dementia tests.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Performance in MMSE and MoCA-A by subgroups.
MCI: mild cognitive impairment; MD: mild dementia; MoCA-A: Montreal Cognitive Assessment adapted to Argentine population; MMSE: Mini-Mental State Examination; ªANOVA.
Figure 2
Figure 2. ROC curves for MMSE and MoCA tests for the detection of MCI.
ROC curve determining cut-off score to distinguish controls (normal cognition) from patients with MCI (mild cognitive impairment) using the MOCA-A, and MMSE.
See this image and copyright information in PMC

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