The Montreal Cognitive Assessment—Basic: A Screening Tool for Mild Cognitive Impairment in Illiterate and Low‐Educated Elderly Adults

Objectives To assess the validity of a newly developed cognitive screening tool, the Montreal Cognitive Assessment—Basic (Mo CA ‐B), in screening for mild cognitive impairment ( MCI ) in elderly adults with low education and varying literacy. Design Cross‐sectional. Setting Community hospital in Bangkok, Thailand. Participants Cognitively normal controls (n = 43) and individuals with MCI according to the National Institute on Aging‐Alzheimer's Association work group criteria (n = 42) aged 55 to 80 with less than 5 years of education. Measurements Mo CA ‐B scores. Results Mean Mo CA ‐B scores were 26.3 ± 1.6 for illiterate controls and 21.3 ± 3.8 for illiterate participants with MCI ( P < .001) and 26.6 ± 2.0 for literate controls and 23.0 ± 2.1 for literate participants with MCI ( P < .001). Mo CA ‐B scores did not differ significantly according to literacy, and multiple regression suggested no association with age or education. The optimal cutoff score of 24 out of 25 yielded 81% sensitivity and 86% specificity for MCI (area under the receiver operating characteristic curve = 0.90, P < .001). Test–retest reliability was 0.91 ( P < .001), and internal consistency was 0.82. Administration time was 15 to 21 minutes. Conclusion The Mo CA ‐B appears to have excellent validity and addresses an unmet need by accurately screening for MCI in poorly educated older adults regardless of literacy.