Cross-Cultural Adaptation and Psychometric Properties of Version 8 of the Montreal Cognitive Assessment (MOCA) In Detecting Mild Cognitive Impairment and Dementia among Older People in Tanzania, A Methodological study/Diagnostic accuracy comparative study

Background The early detection of cognitive deficits in older individuals in Tanzania, particularly those in urban areas with higher levels of education, requires the use of standardized and internationally recognized assessment tools. MoCA version 8, which assesses eight cognitive domains, has been modified to enhance scoring precision and includes instructions on calculating the memory index score (MIS). Additionally, the verbal fluency and abstraction tasks have been revised to facilitate the design of targeted interventions. This study aims to culturally adapt MoCA 8 into Swahili and evaluate its validity, reliability, and diagnostic accuracy for assessing cognitive function in older Tanzanians. Method/design In this methodological study, 240 older individuals (aged ≥50 years) will be recruited from ten randomly chosen villages in both rural and urban areas of the Dodoma region. The MoCA version 8 will serve as the primary screening test, while the MoCA-5minutes protocol will be used as the reference standard screening test. The diagnostic accuracy (power) of the MoCA version 8 will be assessed by comparing its scores with the diagnosis made by a Neurologist using DSM-5 criteria. Data collection will commence after obtaining informed consent to confirm participants' eligibility for the study. The main areas of interest include the Swahili version, validity, reliability, and diagnostic accuracy of MoCA version 8. The Validity, Reliability, Sensitivity, Specificity, Predictive (positive and negative) values will also be reported. Discussion The results of this study will determine whether MoCA 8 is a valid, reliable and accurate screening tool in detecting cognitive function of older people in Tanzania, this will serve as a study to inform the literature and to indicate the manner in which early detection of cognitive impairment will inform early intervention to improve cognitive function.