Validity and reliability of the Spanish Version of the Montreal Cognitive Assessment (MoCA) for the detection of cognitive impairment in Mexico

Aguilar-Navarro, Sara; Mimenza-Alvarado, Alberto J.; Palacios-García, Alberto A.; Samudio-Cruz, Alejandra; Gutiérrez-Gutiérrez, Lidia; Ávila-Fuñes, José Alberto

doi:10.1016/j.rcpeng.2018.10.004

Cited by 25 publications

(33 citation statements)

References 33 publications

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“…All the studies evaluating the MoCA carried out in Colombia reported that the education level biased the results, as did a study performed in Chile on a sample with a high level of education (Delgado et al, 2017). However, the Mexican authors (Aguilar-Navarro et al, 2017), who assessed a population with an education level similar to that of the Chilean sample, found no significant effect of age or education level, which differs from most results reported in the literature. A different study evaluated Brazilian patients with Parkinson's disease, 65% of whom had less than 8 years of education, as part of the LARGE-PD study.…”

Section: Discussionmentioning

confidence: 67%

“…After applying the MTRQ/MCAR to the 14 remaining publications, a study validating the Manos version of the clock-drawing test was also excluded (Custodio et al, 2011 ) as the translation and cultural adaptation process was not described. Finally, 13 publications were selected for the definitive analysis (see the description in Table 2 ), five of which evaluated the MoCA (Pereira-Manrique and Reyes, 2013 ; Pedraza et al, 2016 ; Aguilar-Navarro et al, 2017 ; Delgado et al, 2017 ), three the IFS (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ; Custodio et al, 2016 ), two the M@T (Custodio et al, 2014 , 2017a ), and one the memory, fluency, and orientation (MEFO) test (Delgado Derio et al, 2013 ); the Phototest (Russo et al, 2014 ) and the last one, about Memory Binding Test (MBT) (Roman et al, 2016 ). Of these publications, three were from Chile (Delgado Derio et al, 2013 ; Ihnen Jory et al, 2013 ; Delgado et al, 2017 ), three from Peru (Custodio et al, 2014 , 2016 , 2017a ), three from Colombia (Pereira-Manrique and Reyes, 2013 ; Gil et al, 2014 ; Pedraza et al, 2016 ), three from Argentina (Torralva et al, 2009 ), and one from Mexico (Aguilar-Navarro et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

“…Administration is not standardized; the cultural and socioeconomic characteristics of the patient may bias scores, and the tool can detect dementia only in individuals with at least 5 years of education; the tool does not measure executive function; finally, the MMSE can only detect moderate or advanced dementia, and is not sensitive to early-stage Alzheimer's disease dementia (ADD) or non-Alzheimer's dementias (Dubois et al, 2000 ). Recently, other BCSs have been proposed as substitutes, such as the Montreal cognitive assessment (MoCA) (Gómez et al, 2013 ; Pereira-Manrique and Reyes, 2013 ; Gil et al, 2014 ; Pedraza et al, 2016 ; Aguilar-Navarro et al, 2017 ; Delgado et al, 2017 ), Addenbrooke's cognitive examination (ACE) (Sarasola et al, 2005 ; Custodio et al, 2012 ; Herrera-Pérez et al, 2013 ), ACE-III (Bruno et al, 2017 ), and Addenbrooke's cognitive examination-revised (ACE-R) (Torralva et al, 2011 ; Muñoz-Neira et al, 2012a ; Ospina, 2015 ), as well as complimentary tools designed to measure specific domains such as the memory alteration test (M@T) (Custodio et al, 2014 , 2017a ), INECO frontal screening (IFS) (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ; Custodio et al, 2016 ), and frontal assessment battery (FAB; Dubois et al, 2000 ).…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Custodio

Duque²,

Montesinos

et al. 2020

Front. Aging Neurosci.

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The aim of this study was to evaluate the validity of brief cognitive screening (BCS) tools designed to diagnose mild cognitive impairment (MCI) or dementia in Spanish-speaking individuals over the age of 50 years from Latin America (LA). Methods: A systematic search of titles and abstracts in Medline, Biomed Central, Embase, Scopus, Scirus, PsycINFO, LILACS, and SciELO was conducted. Inclusion criteria were papers written in English or Spanish involving samples from Spanish-speaking Latin American individuals published until 2018. Standard procedures were applied for reviewing the literature. The data related to the study sample, methodology, and procedures applied, as well as the performance obtained with the corresponding BCS, were collected and systematized. Results: Thirteen of 211 articles met the inclusion criteria. The studies primarily involved memory clinic-based samples, with the exception of two studies from an adult day-care center, one from a primary care clinic, and one from a community-based sample. All the studies originated from five of the 20 countries of LA and all used standardized diagnostic criteria for the diagnosis of dementia and MCI; however, the diagnostic protocols applied differed. Most studies reported samples with an average of 10 years of education and only one reported a sample with an average of <5 years of education. No publication to date has included an illiterate population. Although the Montreal cognitive assessment (MoCA) is the most widely-used BCS tool in LA, it is significantly influenced by education level. Conclusions: Although evidence is still limited, the findings from studies on LA populations suggest that MoCA requires cultural adaptations and different cutoff points according to education level. Moreover, the diagnostic validity of the INECO frontal Custodio et al. Brief Cognitive Screenings to Dementia in Latin-America screening (IFS) test should be evaluated in populations with a low level of education. Given the heterogeneity that exists in the levels of education in LA, more studies involving illiterate and indigenous populations are required.

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Section: Discussionmentioning

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Custodio

Duque²,

Montesinos

et al. 2020

Front. Aging Neurosci.

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“…Alternative cognitive assessments such as the SENAS and WAIS‐R have the same bias for education. Good diagnostic performance was reported for culturally adapted versions of the ACE and the MoCA, but all the studies were carried out in H/L countries with convenience samples. These findings must be validated with H/Ls living in the United States before clinician can rely on them.…”

Section: Discussionmentioning

confidence: 99%

Validity of Cognitive Assessment Tools for Older Adult Hispanics: A Systematic Review

Arévalo

Kress

Rodriguez

2019

J American Geriatrics Society

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OBJECTIVES A higher prevalence and incidence of dementia is found in Hispanic/Latino older adults. Therefore, valid instruments are necessary to assess cognitive functioning in this population group. Our aim was to review existing articles that have examined and reported on the validity of cognitive assessment tools in Hispanic/Latino population groups in the United States. DESIGN Systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta‐analysis. MEASUREMENTS We systematically searched in the PubMed and Web of Science databases and assessed the quality of the search results using the Standards for the Reporting of Diagnostic Accuracy Studies. We included evidence from within the United States as well as from Spanish‐speaking countries of origin (Mexico, Central and South America, and the Caribbean). RESULTS The literature search revealed 27 studies with adequate quality that investigated 13 instruments. The Mini‐Mental Status Examination (MMSE) was the most frequently investigated instrument in Hispanic/Latino groups in the United States with high sensitivity for dementia but also with significant differences for ethnicity and education. The Addenbrooke Cognitive Examination‐Revised, Montreal Cognitive Assessment, 10/66 short diagnostic schedule, clock‐drawing test, Phototest, Eurotest, and Executive Battery 25 had good diagnostic performance in Spanish‐speaking countries. The naming test and verbal fluency tests have a higher risk of misclassifying US Hispanics/Latinos who have dementia. CONCLUSION Evidence on validity suggests that the MMSE may be an appropriate cognitive assessment tool for Hispanics. More research is needed to confirm the validity of cognitive tools to assess Hispanic/Latino groups for Alzheimer's disease and other related dementias in the United States to reduce current trends of culturally biased under‐ or overdiagnosis of cognitive impairments. J Am Geriatr Soc 68:882–888, 2020

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“…The Montreal Cognitive Assessment (MoCA) assesses cognitive skills with a maximum possible score of 30 points. A cutoff value of <24 for cognitive decline has been recommended in Mexican population and was used to classify PwP in two groups (normal cognition and cognitive impairment) 19 .…”

Section: Methodsmentioning

confidence: 99%

Malnutrition and Associated Motor and Non-motor Factors in People with Parkinson's Disease

Bazán-Rodríguez

Cruz-Vicioso

Cervantes-Arriaga

et al. 2021

RIC

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Background: People with Parkinson's disease (PwP) are at higher risk of developing malnutrition. Several factors have been suggested to be involved including motor symptoms, non-motor symptoms, and treatment-related complications. Objective: The objective of the study was to analyze the combined effect of motor, non-motor, and pharmacological factors in the risk of malnutrition in PwP. Methods: Eighty-seven consecutive PwP were included in the study. Clinical data and pharmacological treatment were collected. Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) questionnaire. Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-motor Symptoms Scale (NMSS), Hamilton Depression Rating Scale HAM-D, and Montreal Cognitive Assessment were applied. Results: Thirty (34.4%) PwP were at risk of malnutrition and seven had malnutrition (8%). Abnormal nutritional status was associated with lower education, higher MDS-UPDRS Parts I, II, and III and total scores, and higher scores in the NMSS domain of sleep disorders and fatigue. MDS-UPDRS motor score remained as a determinant of abnormal nutritional status, defined as MNA <23.5, with an odds ratio 1.1 (95% confidence interval 1.01-1.10, p = 0.02). Conclusion: The main factor associated with nutritional status was severity of the motor symptoms as assessed by the MDS-UPDRS Part III. Non-motor symptoms and treatment-related complications were not associated with malnutrition. (REV INVEST CLIN. [ahead of print])

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Validity and reliability of the Spanish Version of the Montreal Cognitive Assessment (MoCA) for the detection of cognitive impairment in Mexico

Cited by 25 publications

References 33 publications

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Validity of Cognitive Assessment Tools for Older Adult Hispanics: A Systematic Review

Malnutrition and Associated Motor and Non-motor Factors in People with Parkinson's Disease

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