Masika, Golden MwakiboYu, Doris S. F.Li, Polly W. C.2021-05-262021-05-262019Masika, G. M., Yu, D. S., & Li, P. W. (2019). P2‐452: Applicability of the kiswahili version of montreal cognitive assessment among older adults with very little and no education in rural Tanzania: a validation survey. Alzheimer's & Dementia, 15, P787-P788.DOI: https://doi.org/10.1016/j.jalz.2019.06.2859http://hdl.handle.net/20.500.12661/3226Abstract. Full text article available at https://doi.org/10.1016/j.jalz.2019.06.2859The incidence of dementia in the low and middle‐income countries, particularly sub‐Saharan Africa is rising [1,2]. The Montreal Cognitive Assessment (MoCA) has been widely used to screen for pre‐clinical and clinical stage of this dementia. However, its use in Tanzania is very limited. The aim of this study was to investigate the applicability and psychometrics of the Kiswahili version of MoCA (K‐MoCA) among older adult in the rural Tanzania. The K‐MoCA was administered to 259 community living older adults in Chamwino district, together with the IDEA cognitive screening, IDEA‐Instrumental Activities of Daily Living, and Mental Health Inventory as referencing instruments to examine its concurrent and construct validity. The IDEA was a more validated cognitive test for the Tanzanian population [3]. A subsample (n = 86) were diagnosed by a psychiatrist as 19 having normal cognition, 42 having MCI and 25 having dementia for examining its sensitivity and specificity. The reliability, and correlation of the K‐MoCA with IDEA cognitive screen were also investigated. K‐MoCA demonstrated an acceptable reliability (Cronbach alpha= 0.78) and was significantly correlated with the IDEA cognitive screen (r = 0.651, p < 0.001). Referencing to IDEA scores and psychiatrist rating, the K‐MoCA total and the domain scores except abstraction and delayed recall, were significantly different between subjects with normal cognition, MCI and dementia; which indicated satisfactory discriminant validity (Table 1). Table 2 shows the construct validity of K‐MoCA where the cognitive scores converges with the predicted relationship with age, education and instrumental ADL ability. However, the screening ability (Figure 1 and Figure 2), using the psychiatrist's rating as the golden standard, Receiver Operating Curve analysis, indicated that the recommended cut‐off scores of 26 and 18 did not give acceptable specificities for detecting MCI (Sensitivity: 92%; specificity: 11) and dementia (Sensitivity: 92%; specificity: 55) respectively. The results may be related to the fact that some of the items were less culturally relevant to the Tanzanian population. Overall, the utility of K‐MoCA for detecting MCI and dementia in this population was low due to less cultural relevance of some items. Modification to those items are recommended to improve its utility. its utilityenMontreal cognitive assessmentTanzaniaDementiaMoCAKiswahili psychometricsMental healthArticle