Validity of the Cantonese Chinese Montreal Cognitive Assessment in Southern Chinese.
OBJECTIVE
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.


CONCLUSIONS
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.
Division of Geriatric Medicine, Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong; Alzheimer's Disease Research Network, The University of Hong Kong, Pokfulam, Hong Kong; Research Center of Heart, Brain, Hormone & Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong; Sau Po Center on Aging, The University of Hong Kong, Pokfulam, Hong Kong.
Leung-Wing
LW
Chu
Kathy H Y
KH
Ng
Andrew C K
AC
Law
Antoinette M
AM
Lee
Fiona
F
Kwan
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007802:Language; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014175:Translating
Cantonese; Chinese; Montreal Cognitive Assessment; mild cognitive impairment; screening; validity