Validation of Malay Version of Montreal Cognitive Assessment in Patients with Cognitive Impairment

Abstract

Background: Montreal Cognitive Assessment (MoCA) has been shown to be a sensitive tool for cognitive assessment. There are high proportion of Malaysian elderly with limited proficiency in English language. Malay language is a more familiar language across the multiracial population of Malaysia. Objective: The aim of this study is to validate the Malay version of Montreal Cognitive Assessment (MMoCA) in cognitive impairment patients. Methods: Elderly aged 60 years and above were recruited by using convenient sampling method from 4 government hospitals. Subjects were categorized into normal control group versus patients group with cognitive impairment (Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI)). All subjects completed MMoCA & MMSE-Malay version, followed by a second assessment, which involved Clinical Dementia Rating (CDR), clinical neurological and psychiatry assessment. Results: Total of 66 subjects was enrolled in the study, 44 were normal control, 14 with AD, 8 with MCI. MMoCA is better than MMSE-Malay in differentiating CDR 0 from CDR > 0. With the cut off point of less than 22, MMoCA has the sensitivity of 0.824 and specificity of 0.818 to detect cognitive impairment. Whereas MMSE-Malay only has sensitivity of 0.765 and specificity of 0.636 with the cut off point of less than 27. Conclusion: The MMoCA is a validated and useful cognitive screening instrument in patients with cognitive impairment.