The Moroccan MoCA test: Translation, cultural adaptation, and validation

Area of Science:

• Neurology
• Psychometrics
• Cross-cultural adaptation

Background:

• Dementia diagnosis relies on cognitive assessments.
• Existing tools may not be culturally relevant or linguistically accessible in diverse regions.
• The Moroccan population requires a validated cognitive screening tool.

Purpose of the Study:

• To translate and culturally adapt the Montréal Cognitive Assessment (MoCA) for the Moroccan context.
• To evaluate the diagnostic accuracy of the Moroccan MoCA compared to the Mini-Mental State Examination (MMS).

Main Methods:

• The English MoCA (version 8.1) was translated into Moroccan Darija, Tamazight (including variants), and Arabic.
• The translated MoCA was validated in participants over 50 years old from the Fez-Meknes region.
• Sensitivity, specificity, and internal reliability (Cronbach's alpha) were calculated for both MoCA and MMS.

Main Results:

• The Moroccan MoCA demonstrated high sensitivity (88.5%) and specificity (93.8%).
• The Mini-Mental State Examination (MMS) showed sensitivity of 90.2% and specificity of 90.8%.
• The Moroccan MoCA achieved a higher Cronbach's alpha (0.87) than the MMS (0.79), indicating superior internal reliability.

Conclusions:

• The culturally adapted Moroccan MoCA is a sensitive and specific tool for dementia screening.
• The Moroccan MoCA exhibits high internal reliability, comparable to or exceeding the MMS.
• This validated Moroccan MoCA facilitates dementia screening and research within Morocco and potentially other Arabic-speaking regions.