MoCA in five Indian languages: A brief screening tool to diagnose dementia and MCI in a linguistically diverse setting

Abstract

Introduction and Objectives: Early dementia diagnosis in low and middle-income countries (LMIC) is challenging due to limited availability of brief, culturally appropriate, and psychometrically validated tests. Montreal Cognitive Assessment (MoCA) is one of the most widely used cognitive screening tests in primary and secondary care globally. In the current study, we adapted and validated MoCA in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam) and determined the optimal cut-off points that correspond to screening for clinical diagnosis of dementia and MCI. Methods: A systematic process of adaptation and modifications of MoCA was fulfilled. A total of 446 participants: 214 controls, 102 dementia, and 130 MCI were recruited across six centers. Results: Across five languages, the area under the curve for diagnosis of dementia varied from 0.89 to 0.98 and MCI varied from 0.73 to 0.96. The sensitivity, specificity and optimum cut-off scores were established separately for five Indian languages. Conclusions: The Indian adapted MoCA is standardized and validated in five Indian languages for early diagnosis of dementia and MCI in a linguistically and culturally diverse population.

Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities–focused research

“…The Montreal Cognitive Assessment (MoCA) is a screening tool designed to evaluate individuals with mild cognitive impairment 94 . While the test has been translated widely into > 60 languages, many are merely direct translations; there is then a need to adapt the instrument for cross‐cultural use to ensure validity 95 . The test has also been used as a global cognitive measure in FTD, including a few case‐control studies conducted in diverse populations 96,97 .…”

“…94 While the test has been translated widely into > 60 languages, many are merely direct translations; there is then a need to adapt the instrument for cross-cultural use to ensure validity. 95 The test has also been used as a global cognitive measure in FTD, including a few case-control studies conducted in diverse populations. 96,97 In these studies, the MoCA was essentially used to characterize the overall cognitive profile of the participants, without specific analysis of its diagnostic purposes.…”