Validity of the Cantonese Chinese Montreal Cognitive Assessment in Southern Chinese

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Abstract

Aim:

The objective of the present study was to investigate the reliability and the validity of the Cantonese Chinese Montreal Cognitive Assessment (MoCA) as a brief screening tool of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) in Southern Chinese older adults.

Methods:

Cognitively normal, aMCI and AD Cantonese-speaking Chinese older adults were recruited from a memory clinic and the community. The English MoCA was translated into Cantonese Chinese and then back-translated. We then evaluated the content validity, reliability, sensitivity and specificity of the Chinese Cantonese MoCA.

Results:

We recruited 115 cognitively normal controls, 87 aMCI and 64 AD patients. Only education was positively correlated with the Cantonese MoCA score (r = 0.46, P < 0.001). The Chinese Cantonese MoCA had a high internal consistency with a Cronbach's alpha of 0.85. In the test–retest reliability assessment, the intraclass correlation coefficient (ICC) was 0.95 (P < 0.001). The ICC for the interrater reliability was 0.96 (P < 0.001). Receiving operating characteristic curve analyses showed an area under the curve of 0.85 and 0.99 for aMCI and AD, respectively (both P < 0.001). The optimal cut-off score for detection of aMCI was 22/23, which yielded a sensitivity and specificity of 78% and 73%, respectively. The optimal cut-off score for detection of AD was 19/20, which gave sensitivity and specificity of 94% and 92%, respectively.

Conclusion:

The Cantonese Chinese MoCA is a consistent and reliable instrument. In terms of its validity, the MoCA is better in the detection of AD than aMCI in Cantonese-speaking Chinese persons. It is only fair for the screening of aMCI. Geriatr Gerontol Int 2015; 15: 96–103.

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