The MoCA-S is a screening instrument that could help to identify patients with cognitive impairment and optimize the use of public health resources in a country with limited economic resources. Likewise in the version of Delgado et al., 6 the word “cara” (Face) was changed to “Rostro” (Face) and “Comuna” (Commune) to “localidad” (Town). 1 An example of the importance of cross-cultural adaptation arises from the study conducted by Del Brutto et al., 13 in which more than 70% of the participants could not name ‘rinoceronte’ (Rhino) in the naming subtest, believing it was a “vaca” (Cow), a more common animal in the Ecuadorian rural environment. 12Īccording to various authors, the adaptation of the original version, to compensate for the educational and cultural bias in low and middle-income countries, implies not only a change of cut-off point, but also linguistic and cultural changes that allow a more reliable evaluation.

To date, only one valid MoCA test for screening MCI has been available in Argentina, although this version lacked cross-cultural adaptation to the local environment. 11Īgain, the heterogeneity in cut-off point estimations represents one of the main limitations to the use of the MoCA. 10 In another recent Brazilian study, the most accurate MoCA cutoff was 15 points for dementia diagnosis, while the cutoff was 19 points for MCI diagnosis in a population with heterogeneous educational levels. 9Ī Brazilian study, including a wider range of educational levels, used the more conservative cut-off limit (≤22 points) and found that 67% of their control sample was regarded as cognitively impaired. 8Ī recent systematic review demonstrated that a ≤25-point cutoff could lead to a high rate of false positive diagnoses of cognitive impairment therefore, the authors suggested a cutoff of ≤22 points. 2 However, in populations with a low level of education, adding a single point may be insufficient. The biggest drawback of the MoCA is its high educational bias, thus the original version recommends the addition of a point if educational level is less than 12 years. The study of Pereira-Manrique and Reyes 4 included different cut-off points according to education level. 2 However, some authors have proposed alternative cut-off points, of 21 4 - 6 or 23 points 7 for MCI, and 14 4 or 20 points 6 for mild dementia. Regarding the use of cut-off points for the diagnosis of cognitive impairment, several studies have used the cut-off point of the original study. In addition, the analysis of the effect of education in developing countries is extremely important due to the high percentage of individuals with a low level of education. 1 Latin America is a region that includes a wide variety of heterogeneous nations and therefore, a standardized assessment instrument is required for each country. In reference to Latin America and the Caribbean, the first publications reported date from 2013, i.e. The first Spanish version of the MoCA (MoCA-S), validated in Spain by Lozano et al., 3 was less effective than its original version for the screening of MCI. In the original validation study, with a cut-off ≥26, the MoCA test achieved a screening sensitivity of 90% and 100% for MCI and mild AD respectively, with a specificity of 87%. Original instructions also observed that one point should be added to the total score in individuals with 12 or fewer years of education. It includes 11 subtests evaluating aspects of attention, executive functions, memory, language, visuoconstructional skills, and orientation. The MoCA test requires approximately 10 to 15 minutes to administer. 2 This test was developed to overcome the limitations of the MMSE in diagnosis and differentiation between AD and MCI. The Montreal Cognitive Assessment (MoCA) test was created as an instrument for the detection of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD). The Mini-Mental State Examination (MMSE) has long been the most widely used screening test for cognitive impairment in the clinical setting and the research field.

1 There is a growing need for a brief reliable instrument for detecting dementia in its early stages that can be used in both daily clinical practice and treatment trials. From 2001 to 2040, a 77% increase in the number of people with dementia is expected in Argentina and Chile. The prevalence of dementia in Latin America and the Caribbean is 6-6.5/100 adults over 60 years old.

Moca cognitive assessment test pdf