TRANSCULTURAL ADAPTATION DESIGN OF MONTREAL COGNITIVE ASSESSMENT (MOCA) IN BRAZIL

Introduction: Montreal Cognitive Assessment (MoCA) is the most common cognitive screening instrument for Mild Cognitive Impairment detection. Although the current Brazilian version (MoCA-BR) has been validated, in clinical practice, it is observed that adults with normal cognitive function, especially those less educated, rarely reaches the maximum score of 30 points on the test. Objective: Introduce a methodology to adjust the Brazilian version according to the Brazilian culture. A cross-se Methods: ctional observational study was conducted with 294 participants. In the Memory section, we used the free listing technique to replace words. In the Naming section, an epidemiological survey of the most pinpointed gures was conducted. Replication of Sentence section was modied based on meetings between researchers and Portuguese teachers uent in English. The alternative version of MoCA-BR was composed by: "az Results: ul" (blue), "braço" (arm), "orquídea" (orchid), "seda" (silk) and “igreja” (church) in Memory Section; giraffe, elephant, and lion in the Naming section; “Eu só sei que é João quem será ajudado hoje” and "O gato sempre se esconde embaixo do sofá quando o cachorro está na sala" in the Replication of Sentence section. Our Conclusions: data reinforce the need to adapt the MoCA-BR. We present an alternative version of MoCA-BR, which contemplates the linguistic and cultural requirements of the transcultural adaptation process. The next step is to apply this version to obtain its validation. We believe that this adaptation may allow a future better applicability of the MoCA-BR, especially in less educated people, without underestimating the scores of cognitively normal individuals

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VALIDATION OF THE ALTERNATIVE BRAZILIAN VERSION OF THE MONTREAL COGNITIVE ASSESSMENT (MOCA-BR): PILOT STUDY

10.5327/1980-5764.rpda027 ◽

2021 ◽

Author(s):

Alana Pecorari ◽

Viviane Zétola ◽

Valmir Filho ◽

Paulo Bertolucci ◽

Carolina Ichi ◽

...

Keyword(s):

Cognitive Assessment ◽

Montreal Cognitive Assessment ◽

Healthy Population ◽

Delayed Recall ◽

Brazilian Version ◽

Significant Difference ◽

Alternative Version ◽

Good Internal Consistency ◽

Crosscultural Adaptation ◽

Prospective Longitudinal

Background: The current version of the Brazilian Montreal Cognitive Assessment (MoCA-BR) did not have a reliable cross-cultural adaptation to Brazil-ian Portuguese. In previous stages of this study, the Alternative Version of the MoCA-BR was developed, with changes in the sections: Memory and Delayed Recall, Language and Naming. Objectives: to verify the influence of crosscultural adaptation on the performance of cognitive tools, and the accuracy of the Alternative Version of the MoCA-BR. Methods: a pilot, prospective, longitudinal and analytical study. Both versions of the test were applied in a randomized and cognitively healthy population, between 18 and 60 years, within a medium interval of 54,56 days between the questionnaires. Results: out of 104 participants, 70 were included (64.3% female, 40.2 years). The alternative version obtained superior performances in the naming domain (p < 0.001), and in the adapted sentence in the language domain (p = 0.003). There was no significant difference in the delayed recall domain. The alternative version showed good internal consistency, with a Cronbach’s alpha of 0.75. The cutoff point suggested by the study is 27 points, with sensitivity and specificity of 91.3% and 79.2%, respectively. Conclusions: Cultural factors affect the accuracy of cognitive tests, and adaptation is essential for their use in different countries.

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Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211002640 ◽

2021 ◽

pp. 089198872110026

Author(s):

Sivan Klil-Drori ◽

Natalie Phillips ◽

Alita Fernandez ◽

Shelley Solomon ◽

Adi J. Klil-Drori ◽

...

Keyword(s):

Cognitive Assessment ◽

Cross Sectional Study ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Cognitive Screening ◽

Cross Sectional ◽

A Prospective Study ◽

Sectional Analysis ◽

State Examination ◽

Normal Cognition

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.

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Validating a Pragmatic Approach to Cognitive Screening in Stroke Prevention Clinics Using the Montreal Cognitive Assessment

Stroke ◽

10.1161/strokeaha.115.011036 ◽

2016 ◽

Vol 47 (3) ◽

pp. 807-813 ◽

Cited By ~ 6

Author(s):

Richard H. Swartz ◽

Megan L. Cayley ◽

Krista L. Lanctôt ◽

Brian J. Murray ◽

Eric E. Smith ◽

...

Keyword(s):

Cognitive Assessment ◽

Stroke Prevention ◽

Montreal Cognitive Assessment ◽

Cognitive Screening ◽

Pragmatic Approach

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Validation of the Sinhala Version of the Addenbrooke’s Cognitive Examination-Revised for the Detection of Dementia in Sri Lanka: Comparison with the Mini-Mental Status Examination and the Montreal Cognitive Assessment

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000497743 ◽

2019 ◽

Vol 47 (4-6) ◽

pp. 198-208 ◽

Cited By ~ 1

Author(s):

Vindika Suriyakumara ◽

Srinivasan Srikanth ◽

Ruwani Wijeyekoon ◽

Harsha Gunasekara ◽

Chanaka Muthukuda ◽

...

Keyword(s):

Sri Lanka ◽

Diagnostic Accuracy ◽

Cognitive Assessment ◽

Intraclass Correlation ◽

Screening Tools ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Cognitive Screening ◽

Dementia Prevalence ◽

Addenbrooke’S Cognitive Examination

Background: Sri Lanka is a rapidly aging country, where dementia prevalence will increase significantly in the future. Thus, inexpensive and sensitive cognitive screening tools are crucial. Objectives: To assess the reliability, validity, and diagnostic accuracy of the Sinhalese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R s). Method: The ACE-R was translated into Sinhala with cultural and linguistic adaptations and administered, together with the Sinhala version of the Montreal Cognitive Assessment (MoCA), to 99 patients with dementia and 93 gender-matched controls. Results: The ACE-R s cutoff score for dementia was 80 (sensitivity 91.9%, specificity 76.3%). The areas under the curve for the ACE-R s, Mini-Mental State Examination (MMSE) and MoCA were 0.90, 0.86, and 0.86, respectively. The ACE-R s had good interrater reliability (intraclass correlation = 0.94), test-retest reliability (intraclass correlation = 0.99), and internal consistency (Cronbach’s α = 0.8442). Conclusions: The ACE-R s is sensitive, specific and reliable to detect dementia in persons aged ≥50 years in a Sinhala-speaking population and its diagnostic accuracy is superior to previously validated tools (MMSE and MoCA).

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P1508COGNITIVE IMPAIRMENT A RISK FACTOR FOR NON ADHERENCE TO MEDICAL MANAGEMENT AMONG PATIENTS ON MAINTENANCE HEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1508 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Larisa Shehaj ◽

Merita Rroji (Molla)

Keyword(s):

Cognitive Assessment ◽

Descriptive Analysis ◽

Strong Association ◽

Montreal Cognitive Assessment ◽

Maintenance Hemodialysis ◽

Medical Adherence ◽

Cognitive Screening ◽

High Prevalence ◽

The Mean ◽

And Gender

Abstract Background and Aims Patients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment (CI) compared with the general population. Subtle changes can impact engagement with healthcare, comprehension, decision-making, and medication adherence. The Montreal Cognitive Assessment (MoCA) test was reported to represent a suitable cognitive screening tool for hemodialysis patients. Our study aimed to assess the prevalence of CI in CKD patients undergoing hemodialysis, socio-demographic and patient-related variables affecting CI and relationship with medical adherence. Method Out of 65 patients in the HD unit, 58 patients (mean age 59.16±10.61 years old and meantime in therapy 6.93±5.03 years) accepted to participate in the study. The Montreal Cognitive Assessment (MoCA) scale was administered to patients. Patients with a MoCA global score 24/30 were considered cognitively impaired. Descriptive analysis was done for the socio-demographic and clinical variables. Results The mean total MoCA score for all the patients were 22.77679±3.8. Thirty seven patient 63.7% were evaluated with CI where 67.5 % with Mild CI (MCI) and 32.5% with severe CI (SCI) under 20 points). MoCA subscale analysis revealed that the mean score for visuospatial/executive domain and attention were the lowest with 5.38±1.3 /8max and 2.82±1.67/6 max and scores for orientation were the highest 5.94±0.59/6 max. MCI was related to vintage to dialysis (p < .00001) and education years (p<0.05) but not with age (p>0.05) and gender (p>0.05) where severe CI was related to age and comorbidity ( p<0.05 and P<0.01, respectively. We found a strong association between low scores and medical adherence (p<0.001). Conclusion: In hemodialysis, we have a relatively high prevalence of CI and screening for impairment should be considered in all adults with ESRD. Older age, vintage on dialysis, and comorbidity were associated with lower scores. The visuospatial/executive domain and attention were mostly affected. The association between low scores and medical adherence show a high risk for this group of patients.

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Short Montreal Cognitive Assessment

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988716673469 ◽

2016 ◽

Vol 30 (2) ◽

pp. 104-108 ◽

Cited By ~ 14

Author(s):

A. J. Larner

Keyword(s):

Cognitive Impairment ◽

Cognitive Assessment ◽

Computerized Adaptive Testing ◽

Montreal Cognitive Assessment ◽

Test Accuracy ◽

Cognitive Screening ◽

Memory Clinic ◽

Subjective Memory ◽

Index Study ◽

Diagnosis Of Dementia

The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.

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MONTREAL COGNITIVE ASSESSMENT VS. ROWLAND UNIVERSAL DEMENTIA ASSESSMENT SCALE FOR COGNITIVE SCREENING

Innovation in Aging ◽

10.1093/geroni/igx004.1667 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 468-468 ◽

Cited By ~ 1

Author(s):

C. Brymer ◽

C. Sider ◽

A. Evans ◽

B.Y. Lee ◽

K. Taneja ◽

...

Keyword(s):

Cognitive Assessment ◽

Assessment Scale ◽

Montreal Cognitive Assessment ◽

Cognitive Screening

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Montreal Cognitive Assessment in a 63- to 65-year-old Norwegian Cohort from the General Population: Data from the Akershus Cardiac Examination 1950 Study

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000480496 ◽

2017 ◽

Vol 7 (3) ◽

pp. 318-327 ◽

Cited By ~ 2

Author(s):

Håkon Ihle-Hansen ◽

Thea Vigen ◽

Trygve Berge ◽

Gunnar Einvik ◽

Dag Aarsland ◽

...

Keyword(s):

Higher Education ◽

General Population ◽

Cognitive Assessment ◽

Population Data ◽

Montreal Cognitive Assessment ◽

Cross Sectional ◽

Normal Cognitive Function ◽

The Mean ◽

The Impact ◽

Moca Score

Aims: To investigate Montreal Cognitive Assessment (MoCA) test scores in a cohort aged 63–65 years from a general population in relation to the proposed cut-off score of 26 for mild cognitive impairment (MCI) and to explore the impact of education. Methods: MoCA scores were assessed in the Akershus Cardiac Examination 1950 Study, a cross-sectional cohort study of all men and women born in 1950 living in Akershus County, Norway. The participants were aged 63–65 at the time of data collection. Results: MoCA scores were available in 3,413 participants, of which 47% had higher education (>12 years). The mean MoCA score was 25.3 (95% confidence interval [CI] 25.2–25.4), and 49% had a score below the suggested cut-off of 26 points. Those with higher education had significantly higher scores (mean 26.2, 95% CI 26.1–26.3 vs. 24.4, 95% CI 24.3–24.6, p < 0.001). Conclusions: Approximately 50% scored below the cut-off score of 26 points, suggesting that the cut-off score may have been set too high to distinguish normal cognitive function from MCI. Educational level had a significant impact on MoCA scores.

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Converting from the Montreal Cognitive Assessment to the Mini-Mental State Examination-2

PLoS ONE ◽

10.1371/journal.pone.0254055 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254055

Author(s):

Hwabeen Yang ◽

Daehyuk Yim ◽

Moon Ho Park

Keyword(s):

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Intraclass Correlation ◽

Montreal Cognitive Assessment ◽

Cognitive Screening ◽

Conversion Table ◽

Linear Smoothing ◽

Log Linear ◽

State Examination

Objective The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination-2 (MMSE-2) are useful psychometric tests for cognitive screening. Many clinicians want to predict the MMSE-2 score based on the MoCA score. To facilitate the transition from the MoCA to the MMSE-2, this study developed a conversion method. Methods This study retrospectively examined the relationship between the MoCA and MMSE-2. Overall, 303 participants were evaluated. We produced a conversion table using the equipercentile equating method with log-linear smoothing. Then, we evaluated the reliability and accuracy of this algorithm to convert the MoCA to the MMSE-2. Results MoCA scores were converted to MMSE-2 scores according to a conversion table that achieved a reliability of 0.961 (intraclass correlation). The accuracy of this algorithm was 84.5% within 3 points difference from the raw score. Conclusions This study reports a reliable and easy conversion algorithm for transforming MoCA scores into converted MMSE-2 scores. This method will greatly enhance the utility of existing cognitive data in clinical and research settings.

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Comparative assessment of Montreal Cognitive Assessment (MOCA) and Minimental State Examination (MMSE) in apolipoprotein E (APOE) ɛ4 allele carriers in epilepsy

International Journal of Epilepsy ◽

10.1016/j.ijep.2015.11.002 ◽

2016 ◽

Vol 03 (01) ◽

pp. 007-011 ◽

Cited By ~ 2

Author(s):

Amirthalingam Palanisamy ◽

Natham Rajendran ◽

Mukundhu Narmadha ◽

Ruckmani Ganesvaran

Keyword(s):

Cognitive Impairment ◽

Apolipoprotein E ◽

Cognitive Assessment ◽

High Sensitivity ◽

Educational Status ◽

Cognitive Status ◽

Montreal Cognitive Assessment ◽

Normal Cognitive Function ◽

E4 Allele ◽

State Examination

AbstractBackground/Aim Mini mental state examination (MMSE) is a widely accepted tool till date to investigate cognitive status; however, its sensitivity is questioned by few studies. Alternately, Montreal cognitive assessment (MOCA) is considered more effective with high sensitivity to assess cognitive status than MMSE. The usefulness of MOCA is well established in assessing cognitive status in patients in various disorders. Apolipoprotein E (APOE) ɛ4 allele is identified as one of the risk factors associated with cognitive impairment on MMSE; however, the usefulness of MOCA on the association between APOE ɛ4 allele and cognitive impairment is not clearly established and hence the present study.Methods This prospective study recruited 123 subjects diagnosed as tonic-clonic seizures in the study site during the study period.Results Gender and educational status showed normal cognitive function on MMSE but showed cognitive impairment on MOCA. Among epilepsy patients, all APOE ɛ4 carriers showed mild to severe cognitive impairment on MOCA but differences in cognitive status were observed in this population as well as in APOE ɛ4 non-carriers on MMSE.Conclusion Thus, the present study demonstrates the sensitivity of MOCA over MMSE in detecting cognitive impairment in epilepsy.

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