Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients.

OBJECTIVE The Montreal Cognitive Assessment (MoCA) is an instrument that aids clinicians in detecting mild cognitive impairment and early Alzheimer's disease. The study aimed to adapt the MoCA for use in the Philippines, and determine its psychometric validity when used in the Filipino setting. METHODS The MoCA was adapted by a multidisciplinary team working at the Memory Center of St. Luke's Medical Center, Manila, the Philippines. Contextual adaptation, rather than direct translation, was done. Pilot testing of the Filipino version of the MoCA (MoCA-P) was done on 12 grade 6 pupils and subsequently on 14 cognitively intact elderly people. Reliability testing of the MoCA-P was done on 25 elderly people by trained psychologists. Internal consistency, inter-rater and intra-rater reliability, as well as convergent and divergent validity of the MoCA-P were determined. RESULTS The MoCA-P yielded a high level of internal consistency (Cronbach's alpha; = 0.938). Inter-rater and intra-rater reliability were 0.887 (p ≤ 0.05) and 0.969 (p ≤ 0.05), respectively. The MoCA-P correlated negatively with the Epworth Sleepiness Scale (r = -0.233) and had a positive but low correlation with the Mini-Mental State Examination (r = 0.555). CONCLUSION Contextual translation and pilot testing yielded several modifications of the MoCA. The MoCA-P is a reliable instrument for use in elderly Filipino patients. Further diagnostic validation of the MoCA-P to establish cutoff scores that would discriminate elderly individuals with normal cognition from those with dementia is needed to establish the clinical utility of the test.