The concordance between the Montreal cognitive assessment and the repeatable battery for the assessment of neuropsychological status as a cognitive screening tool in a south African community sample.

We aimed to compare the concordance between the Montreal Cognitive Assessment (MoCA) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as cognitive screening tools to detect mild cognitive impairment (MCI) in a South African adult community sample ( = 370). The MoCA showed acceptable internal consistency, agreement with the RBANS and good criterion-related validity. The MoCA demonstrated fair performance, compared to the RBANS, for predicting MCI, with AUCs of 0.711 (English) and 0782 (Afrikaans). Using the recommended cut-off score of 26/30, the MoCA showed high sensitivity but low specificity. Sensitivity and specificity were optimal when the cut-off scores were lowered to 25/30 (English) and 24/30 (Afrikaans). MoCA scores were significantly associated with language, sex, age and education. While these findings demonstrate applicability of the MoCA in screening for and identifying mild cognitive difficulty in this population, our findings suggest that modifications are needed to improve differentiating between normal aging and MCI. Until a culturally adapted version of the MoCA is developed and validated for this population we suggest lowering the cut-off score to 25/30 (English) and 24/30 (Afrikaans) to reduce false positive NCD diagnoses. Demographic factors (age, sex, language and education) also need to be considered.