Optimal cutoffs for the Montreal Cognitive Assessment among English and Spanish speaking Latinos

Commonly applied cutoff scores of the Montreal Cognitive Assessment (MoCA) perform poorly among US Latinos. Prior studies relied on small samples, combining persons with mild cognitive impairment (MCI) and dementia into a single group, or failing to account for multiple intersecting demographic factors. We identified optimal MoCA cutoffs for MCI and dementia while addressing these limitations, cross-sectionally, among 1,780 English- and Spanish-speaking Latinos. Research diagnostic groups consisted of cognitively unimpaired (CU), MCI, and dementia. Area under the curve (AUC) values for CU vs. MCI were 0.70 for Spanish-tested participants and 0.75 for English-tested participants, while values for MCI vs. dementia were 0.83 and 0.84 for the Spanish and English tested participants, respectively. Generally, there was a pattern of lower cutoffs for both MCI and dementia among Spanish speakers at older ages and lower educational attainment, with some optimal cutoffs shown to be substantially lower than the traditionally used standard cutoff. These findings provide cutoffs that better reflect differences amongst language and demographic groups.