Background: Most older adults with dementia reside in low- and middle-income countries where illiteracy and low educational background are common. It is quite challenging to diagnose dementia and mild cognitive impairment in this specific group for multiple reasons including difficult access to health care resources and the availability of an appropriate cognitive tests without high verbal and educational demands.
Aim: to evaluate the performance of low-educated and illiterate elderly in Egypt using the Montreal Cognitive Assessment Basic (MoCA-B).
Patients and methods: cross-sectional design included 100 elderly participants recruited from Ain Shams University clinics especially geriatrics clinic. Demographic data of the participants were collected. Assessment of cognition with grading the severity of cognitive impairment by clinical dementia rating (CDR) was done, with assessment of cognition by Montreal Cognitive Assessment Basic (MoCA-B) to evaluate performance and diagnostic accuracy.
Results: Diagnostic performance of MOCA-B score was moderate in all the participants, high in 6-9 years and 1-5 years of education, and lowest in illiterates. The cut point in participants with 6-9 years of education was lower than that of standard MOCA-B scoring, to be ≤23, it decreased to be ≤22 in participants with 1-5 years of education, then to ≤21 in illiterate participants.
Conclusions: The Arabic MoCA-B has proven a moderate diagnostic performance for detecting Mild Cognitive Impairment in illiterate and low educated Egyptian elderly after modifying the cutoff points to (≤23 in 6-9 years of education, ≤22 1-5 in years of education and ≤21 in illiterate).