Exploring the Influence of Demographic Variables on Total MoCA Score in a South African Adult Population

The Montreal Cognitive Assessment (MoCA) is a widely used rapid screening instrument for mild cognitive dysfunction, designed to assess various cognitive domains such as attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. In this study, we aimed to explore the influence of demographic variables on total MoCA score, calculate the psychometric properties of the MoCA, and provide normative data for a well-defined sample of South African adults who are English second- or third-language speakers and have attained public education.

Our sample consisted of 70 patients with human immunodeficiency virus (HIV) and comorbid psychiatric disorder, 13 patients with HIV and comorbid neurocognitive disorder (NCD), and 89 unaffected controls. All participants completed the English MoCA version 8.1. Our results showed that total MoCA scores were significantly correlated with years of education (p<0.001) and age (p=0.007) but not gender.

We also found poor discriminant validity of the MoCA, as belonging to psychiatric or NCD groups was predicted by age and years of education rather than total MoCA scores. Cronbach’s alpha was 0.64, indicating moderate internal consistency of the MoCA.

The results of this study highlight the importance of considering demographic variables when interpreting MoCA scores in a South African adult population. The findings suggest that the MoCA may not be a reliable tool for diagnosing mild cognitive dysfunction in individuals with lower levels of education and older age. These results have significant implications for healthcare providers, particularly in resource-limited settings such as South Africa.

In conclusion, our study provides normative data for a well-defined sample of South African adults who are English second- or third-language speakers and have attained public education. The findings suggest that the MoCA may not be a reliable tool for diagnosing mild cognitive dysfunction in this population, and highlight the need for further research on the psychometric properties of the MoCA in different cultural and educational settings.

Reference:

Moca test version 8.1 pdf