B-26 Examining Montreal Cognitive Assessment (MoCA) Performance by Primary and Testing Language

Abstract Objective The MoCA has been translated into almost 100 languages including a Spanish version used in multiple validation studies. Research considering primary language and language of test administration is limited. We compared MoCA scores of primary Spanish speakers tested in English (S-E) with those of primary Spanish speakers tested in Spanish (S-S). Method This project involved secondary analysis of deidentified National Alzheimer’s Coordinating Center data. Cases with first visit MoCA data, demographics, and primary language of Spanish were included resulting in a final sample (N = 395) of S-S (n = 265) and S-E (n = 130) participants. Coarsened exact matching was used to derive a sample subset matched on age, education, and Clinical Dementia Rating global score (n = 160). Participants were compared on demographics and MoCA. Results In the final sample, S-S and S-E participants were not different in age, but educational level was lower in S-S (M = 10.0; SD = 5.3) than S-E (M = 14.6; SD = 3.9; p < 0.001) participants. MoCA scores were lower in S-S (M = 19.1, SD = 6.2) than S-E participants (M = 21.2, SD = 6.1; p = 0.002). A larger proportion of the S-S group (79%) had an abnormal MoCA compared to the S-E group (67%; p = 0.021). In the matched sample, MoCA scores were not significantly different between S-S (M = 21.2; SD = 4.8) and S-E (M = 21.2; SD = 5.3; p = 0.95) participants; rates of abnormal MoCA scores were not significantly different between S-S (73%) and S-E (66%; p = 0.39) participants. Conclusions Relationships between primary language, test administration language, and MoCA score were reduced in groups matched on education. Future research should explore additional education and language interactions among bilingual older adults.