The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
Department of Nursing and Midwifery, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
Arch Clin Neuropsychol. 2021 Apr 21;36(3):371-380. doi: 10.1093/arclin/acz086.
The incidence of dementia in the sub-Saharan Africa is rising. However, screening tools for cognitive decline that fits their linguistic and cultural context are lacking. The aim of this study was to determine the accuracy of the Kiswahili version of Montreal Cognitive Assessment (K-MoCA) to detect mild cognitive impairment or dementia among older adults in the rural Tanzania.
We recruited 259 community-dwelling older adults in Chamwino district, Tanzania. The concurrent validity and discriminatory power of K-MoCA were examined by comparing its score with IDEA cognitive screening and psychiatrist's diagnosis using DSM-V, respectively. All the questionnaires were administered in face-to-face interview.
K-MoCA demonstrated acceptable reliability (Cronbach's alpha = 0.780). Concurrent validity was evident by its significant correlation with the IDEA screening test (Pearson's r = 0.651, p < 0.001). Using the psychiatrist's rating as the reference, the optimal cut-off score for MCI and dementia was 19 and 15, respectively, which yielded the sensitivity of 70% and specificity of 60% for MCI, and sensitivity of 72% and specificity of 60% for dementia. Further analysis indicated that education and age influence performance on K-MoCA.
Overall, the K-MoCA is a reliable and valid tool for measuring cognitive decline. However, its limited discriminatory power for MCI and dementia may be compromised by the cultural irrelevance of some items.
撒哈拉以南非洲的痴呆发病率正在上升。然而，适合其语言和文化背景的认知障碍筛查工具却缺乏。本研究旨在确定斯瓦希里语版蒙特利尔认知评估（K-MoCA）在坦桑尼亚农村地区检测老年人轻度认知障碍或痴呆的准确性。
我们在坦桑尼亚 Chamwino 区招募了 259 名社区居住的老年人。通过将 K-MoCA 的分数与 IDEA 认知筛查和使用 DSM-V 的精神病医生诊断进行比较，分别检查了 K-MoCA 的同时效度和判别能力。所有问卷均通过面对面访谈进行管理。
K-MoCA 表现出可接受的可靠性（Cronbach's alpha = 0.780）。与 IDEA 筛查测试的显著相关性表明其具有同时效度（Pearson's r = 0.651，p < 0.001）。使用精神病医生的评分作为参考，MCI 和痴呆的最佳截断分数分别为 19 和 15，其 MCI 的灵敏度为 70%，特异性为 60%，痴呆的灵敏度为 72%，特异性为 60%。进一步分析表明，教育和年龄会影响 K-MoCA 的表现。
总体而言，K-MoCA 是一种可靠且有效的测量认知障碍的工具。然而，其对 MCI 和痴呆的判别能力有限，可能会受到某些项目与文化无关的影响。
