Validity of the Cantonese Chinese Montreal Cognitive Assessment in Southern Chinese

AimThe 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. MethodsCognitively 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. ResultsWe 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. ConclusionThe 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.