title: Use of the MoCA in Detecting Early Alzheimer's Disease in a Spanish-Speaking Population with Varied Levels of Education.
abstract: OBJECTIVE
  Performance on the Montreal Cognitive Assessment (MoCA) has been demonstrated to be dependent on the educational level. The purpose of this study was to identify how to best adjust MoCA scores and to identify MoCA items most sensitive to cognitive decline in incipient Alzheimer's disease (AD) in a Spanish-speaking population with varied levels of education.
  
  
  METHODS
  We analyzed data from 50 Spanish-speaking participants. We examined the pattern of diagnosis-adjusted MoCA residuals in relation to education and compared four alternative score adjustments using bootstrap sampling. Sensitivity and specificity analyses were performed for the raw and each adjusted score. The interval reliability of the MoCA as well as item discrimination and item validity were examined.
  
  
  RESULTS
  We found that with progressive compensation added for those with lower education, unexplained residuals decreased and education-residual association moved to zero, suggesting that more compensation was necessary to better adjust MoCA scores in those with a lower educational level. Cube copying, sentence repetition, delayed recall, and orientation were most sensitive to cognitive impairment due to AD.
  
  
  CONCLUSIONS
  A compensation of 3-4 points was needed for <6 years of education. Overall, the Spanish version of the MoCA maintained adequate psychometric properties in this population.
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Yan
authors: Y
authors: Zhou
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Freddy
authors: F
authors: Ortiz
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA ; Keck School of Medicine, University of Southern California Division of Research on Children, Youth and Families., USA ; Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, Calif., USA.
authors: Christopher
authors: C
authors: Nuñez
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA ; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA)., USA.
authors: David
authors: D
authors: Elashoff
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Ellen
authors: E
authors: Woo
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Liana G
authors: LG
authors: Apostolova
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Sheldon
authors: S
authors: Wolf
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Maria
authors: M
authors: Casado
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Nenette
authors: N
authors: Caceres
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: Hemali
authors: H
authors: Panchal
authors: Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California, Los Angeles (UCLA)., USA.
authors: John M
authors: JM
authors: Ringman
keywords: Alzheimer's disease; Dementia; Education; Hispanic population; Latino population; Mild cognitive impairment; Montreal Cognitive Assessment; Screening; Spanish-speaking population