An Evaluation of the Psychometric Properties of the Montreal Cognitive Assessment Tool when Administered in a Memory Clinic At Groote Schuur Hospital, Cape Town, South Africa

Abstract

Worldwide, the population is aging, and the prevalence of neurocognitive disorders is expected to rise exponentially. Therefore, early detection of dementia is favorable for the patient and may even be of greater significance if disease-modifying treatments are discovered. The Montreal Cognitive Assessment (MoCA) is a reliable and valid cognitive screening tool but is sensitive to several sociodemographic factors, including language, culture, and quality of education. This underscores the need for cognitive screening scales validated in the culturally diverse South African setting. Aim. The purpose of this study was to investigate the utility of the MoCA as a brief cognitive screening tool in a specialized clinical South African sample. Methods. A retrospective medical folder review of 162 patients seen at Groote Schuur Hospital Memory Clinic for the first time between January 2014 and August 2021. Results. The median age of participants was 67 years (IQR 58-73). Most were females (63%, n =102), and had dementia (58%, n = 94); more than half (51%, n = 78) had at least 12 years of formal education. Older age and lower levels of education were associated with lower MoCA scores (p < 0.001). Conclusion. In a specialized South African clinical setting, the MoCA demonstrated good psychometric properties as a screening tool for evaluating different levels of cognitive impairment. However, to our knowledge, this is the first South African study to assess the factor structure of the MoCA in a clinical setting. More comprehensive and larger studies should evaluate the validity of our findings