VALIDATION AND CUT-OFF SCORES OF MONTREAL COGNITIVE ASSESSMENT FOR ELDERLY VISUALLY IMPAIRED

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Norliza Mohamad Fadzil
Qiu Ting Kee
Mohd Harimi Abd Rahman
Zainora Mohammed
Normah Che Din
Suzana Shahar

Abstract

This study aimsto determine the reliability and validity and optimal cut-off scores of the Malay version of Montreal
Cognitive Assessment for visually impaired (MoCA-BM-blind) among older adults with cognitive decline. Participants
for this study were recruited from the population-based longitudinal study on neuroprotective model for healthy
longevity (LRGS TUA) among Malaysian older adults. A total of 220 participants, aged 60 years and above, from
Selangor were included in this study. Cognitive functions were assessed using MoCA-BM-blind and Malay version
of Mini-Mental State Examination for visually impaired (M-MMSE-blind). Habitual distance VA was measured
monocularly using the Early Treatment Diabetic Retinopathy Study chart. Cronbach’s alpha and Pearson correlation
coefficient were used to determine reliability and validity of MoCA-BM-blind, respectively. Receiver operating
characteristic (ROC) analysis was conducted to determine the optimal cut-off score for MoCA-BM-blind. Reliability
(Cronbach’s alpha: 0.76) and validity (Pearson correlation: r = 0.77) of MoCA-BM-blind were high. The optimal cutoff for MoCA-BM-blind in detecting cognitive decline was 9 with 86.8% sensitivity and 72.7% specificity. With this
cut-off, 35.0% visually impaired participants were classified as having cognitive decline. MoCA-BM-blind is a valid
and reliable screening tool to assess cognitive function among visually impaired older adults.

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Research article