Adaptation and Validation of the Tamil (Sri Lanka) Version of the Montreal Cognitive Assessment (MOCA)

The study aimed to develop the Tamil (Sri Lanka) version of the Montreal Cognitive Assessment (MoCA) and investigate its reliability and validity as a brief screening tool for mild cognitive impairment (MCI). Tamil-speaking Sri Lankan older adults with normal cognition and MCI were recruited from a neurology clinic. Adaptation of the English MoCA to the Tamil (Sri Lanka) involved context-specific content modification and translation. The content validity, reliability, sensitivity, and specificity of the tool were evaluated. Study participants were 184 older adults, comprising 85 with normal cognition and 99 neurologist-diagnosed MCI. The tool had high internal consistency (Cronbach's alpha=0.83). ROC curve analyses showed an area under the curve of 0.87 (95% CI 0.83-0.91) for detecting MCI. The optimal cut-off score for detection of MCI was 23/24, yielded a sensitivity and specificity of 84.7% and 76.4%, respectively. The Tamil (Sri Lankan) version of the MoCA maintains its core diagnostic properties rendering it a valid and reliable tool for screening of MCI among Tamil speaking Sri Lankan older adults.