In addition, Asian Americans in general are at a particularly high risk for viral hepatitis. 13 VAs also have markedly higher incidences of cervical and liver cancer compared to any other ethnic groups. For instance, compared to other Asian American subgroups, VA women had the highest rates of stroke and dementia. Several medical conditions associated with increased risks of cognitive decline were common among Vietnamese. 9–11 A recent study of the MoCA test in Vietnamese included a very small sample (n=7) of Vietnamese older adults who had been diagnosed with dementia or neurocognitive disorder. 5–7 Research with a community-based sample, where the MoCA and MMSE scores were compared 8 or the internal reliability and construct validity of the MoCA test were examined remains limited. 4 In more recent validations of the MoCA test in languages other than English, the test scores were also compared between groups with and without a clinical diagnosis of cognitive impairment. In many studies, the MoCA test and subtests have primarily been validated against either a clinical diagnosis or the Mini Mental Status Examination (MMSE) score, another tool also widely used for MCI screening. Koski 3 summarized this literature within the context of cerebrovascular diseases, where cognitive impairment is a common consequence. With a score between 0 and 30 points, the MoCA has the ability to assess multiple cognitive domains 1,2 it has been used in more than 200 countries in different languages, and available for clinical and educational use from Many researchers have validated the MoCA test the vast majority of such studies were with patient populations - those at risk or already diagnosed with cognitive impairments. The Montreal Cognitive Assessment (MoCA) 1 is a simple and user friendly tool widely used for screening mild cognitive impairment (MCI), a transitional stage between normal aging and dementia. The promising performance of a Vietnamese version of the MoCA test seen in this study has important practical implications for the screening of MCI among an important immigrant population in community settings. The study suggests several potential areas for improvement to enhance discriminating power of certain items and sub-tests, including the memory domain. The test was found to be a reliable, and likely valid, instrument for mild cognitive impairment (MCI) screening within our study population. Our findings indicate good psychometric applicability and internal reliability, as well as construct and criterion validity of this modification of the MoCA test. We also correlated the MoCA score with individual characteristics, including age, sex, and education. Item analyses, and construct and criterion validity analyses were performed. METHODSįorty-eight older adults were interviewed using a Vietnamese version of MoCA. MCI MoCA adults cognitive decline cutoff highly educated neuropsychological tests.The goal of this study was to assess how the Vietnamese version of the MoCA test performed in a community-based sample of Vietnamese American (VA) older adults, an immigrant population with whom the MoCA test has not been validated. Therefore, it is crucial to use the age- and education-related norms for the MoCA in order to avoid misdiagnosis of cognitive decline. Our study demonstrates that the currently used MoCA cutoff is too high even for highly educated, cognitively normal older adults. However, in substantial contrast, all other neuropsychological scores and the MoCA standardized scores were within the normal range and even above in all years. From the second year and forward, the average MoCA total score was below the cutoff of 26/30. Repeated-measures ANOVA for MoCA raw scores yielded significant decline across the years ( P <. Repeated measures analysis of variance (ANOVA) was used to analyze all standardized scores as well as MoCA standardized and raw scores across all years. The cognitive assessment included MoCA Rey Auditory Verbal Learning Test Rey Osterrieth Complex Figure test Wechsler Adult Intelligence Scale Information and Digit Span Subtest Trail Making Test Verbal Fluency Test and Beck Depression Inventory questionnaire. Twenty-seven participants aged 68 to 83 (mean = 75.07, standard deviation = 4.62), with high education level (mean = 17.14 years, SD = 3.21) underwent cognitive assessment once a year for 5 consecutive years. To identify whether the MoCA cutoff is too stringent for cognitively normal older adults. Although, age and education-related norms have been published, the vast majority of diagnostic clinicians use the MoCA cutoff score to identify patients with cognitive impairment. The Montreal Cognitive Assessment (MoCA) is widely used to evaluate cognitive decline in older individuals.
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