Montreal Cognitive Assessment in Spanish‐speaking countries in Latin America and the Caribbean: A Systematic Review
Bibliographic record
Abstract
Abstract Background The prevalence of dementia in Low and Middle‐Income Countries (LMICs), particularly in Latin America and the Caribbean (LAC), is projected to triple by 2050. The Montreal Cognitive Assessment (MoCA) is widely used for cognitive evaluation, but its uniform application in LAC is questionable, especially due to cultural and linguistic diversity of the Spanish‐speaking LAC countries. Method A systematic literature search was conducted across seven databases, supplemented by a comprehensive review using Google Scholar to identify relevant grey literature. Studies validating or culturally adapting the MoCA, conducted in Spanish‐speaking institutions in the LAC region, with available psychometric measures and comparisons to gold‐standard diagnostic criteria, were considered for inclusion. Fourteen studies were identified that validated the MoCA in LAC. Twelve studies meeting inclusion criteria were analyzed using the Manchester Cultural Adaptation Questionnaire and Manchester Translation Reporting Questionnaire. The adaptation process and psychometric reports were thoroughly assessed. Result Among all reviewed articles, 12 detailed MoCA validation across LAC populations (Fig. 1). Only two reported significant adaptations to the original version, with one study providing a detailed cultural rationale (Table 1). The adaptation process assessment revealed limited reporting on translation steps (Table 2). Concerning the psychometric report, internal consistency, criterion validity, and construct validity were the most frequently addressed aspects across all studies. In all studies where low‐educated populations were evaluated, educational level was reported to bias the results. We identified a lack of standardized criteria for definition of illiteracy across the studies. Conclusion This systematic review identified limited reporting on translation steps emphasizes the need for standardized processes in future adaptations. We recommend cultural awareness during MoCA administration in the region. Future studies must address appropriate cut‐off scores based on educational level adjustments in LAC countries.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.037 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.012 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".