The Montreal Cognitive Assessment in Spanish-speaking countries in Latin America and the Caribbean: A Systematic Review

The Montreal Cognitive Assessment in Spanish-speaking countries in Latin America and the Caribbean: A Systematic Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Montreal Cognitive Assessment in Spanish-speaking countries in Latin America and the Caribbean: A Systematic Review Adrian Noriega de la Colina, Diego Bustamante Paytan, Angie Díaz Mejía, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3919583/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The worldwide prevalence of individuals living with dementia is on the rise and expected to reach 152.8 million people by 2050. This increase will affect disproportionately Low- and Middle Income Countries, which is already home to 60% of individuals living with dementia. Screening tools for early detection of mild cognitive impairment are crucial to provide patients with adequate diagnosis, timely interventions, and access to disease-modifying therapies. The Montreal Cognitive Assessment (MoCA) is one of the most widely used tests for cognitive assessment of first line, but its uniform application across Latin American and Caribbean (LAC) countries is questionable due to cultural and linguistic differences, a higher prevalence of low educational achievement and socioeconomical disparities. This systematic review for validation of the MoCA in Spanish-speaking LAC countries identified fourteen studies but only included twelve based on inclusion and exclusion criteria. We assessed the articles for cultural adaptation and translation reports using the Manchester Cultural Adaptation Questionnaire and the Manchester Translation Reporting Questionnaire. Only two studies reported significant adaptations to the original MoCA, with one study providing detailed cultural and lexical rationale. The adaptation process assessment revealed limited reporting on the translation steps involved, with few studies detailing the original author's involvement, professional translation, pilot testing, or healthcare professional input. This systematic review suggests the use of suitable cutoff scores, educational level-based scoring adjustments, and cultural awareness are key for adequate screening using the MoCA in LAC Spanish-speaking countries. PROSPERO Study registration number: CRD42023465794. Health sciences/Neurology/Neurological disorders/Neurodegenerative diseases/Alzheimer's disease Health sciences/Neurology/Neurological disorders/Dementia/Alzheimer's disease Figures Figure 1 Figure 2 Introduction The global prevalence of individuals living with dementia is anticipated to surge from 57.4% to 152.8 million by 2050 ( 1 ). This rise in dementia cases will disproportionately impact Low- and Middle-Income Countries (LMICs), primarily due to their populations aging. Already 60% of individuals with dementia live in LMICs, and this figure is projected to elevate to 71% by 2050 ( 2 , 3 ). This comes at a high societal burden and economic costs for affected healthcare systems and societies, for which screening for early diagnosis of mild cognitive impairment and dementia is crucial. Most of the currently used brief cognitive screening (BCT) tools in Latin America and the Caribbean (LAC) were developed and validated in high income countries where higher levels of education are more prevalent. Considering that low levels of education are a risk factor for developing cognitive impairment ( 4 ) and that health systems in LAC countries are inefficient, it is important to develop timely diagnostic strategies for this vulnerable population ( 5 ). An accurate diagnosis of dementia requires a reliable neuropsychological assessment ( 6 ) and the cognitive assessment tools are commonly used for screening impairment, differential diagnosis, determining disease severity, as monitoring disease progression in patients ( 7 ). On this sense, valid tests are needed for assessing individuals across a wide range of cultures and education ( 8 ). This is particularly a challenge in LAC countries, where the largest and most challenging socio-economic inequality in the world are prevail. In this region, education systems reflect the highly unequal societies in which they are located ( 9 ). BCT tools not adapted to age and schooling due to the lack of consciousness of psychometric characteristics constitute the first barrier to an accurate diagnosis, as the design of them are not low-educated specific, for example the reading, writing or copy of geometric figures (10,11). Similarly, the adaptation of non-culturally develop cognitive test could be challenging in some populations (i.e., indigenous participants), thus, culture-free items must be developed. Hence inequity to reach out neurocognitive diagnosis has not been completely solved. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most popular cognitive assessment tools worldwide ( 12 ). Ellison et al. (2022) in their global inter-societal Delphi consensus for outcomes measurements for Alzheimer’s disease, through a strong consensus, recommended the MoCA and the MMSE for the assessment of memory and overall cognitive functioning in mild and moderate disease ( 13 ). Still, they have been shown to have a significant bias related to educational level ( 14 , 15 ). The MoCA developed by Nasreddine et.al. ( 16 ) has demonstrated to be more sensitive than MMSE for Mild Cognitive Impairment (MCI) detection (MoCA 90% vs MMSE 18%), and for mild Alzheimer’s disease (AD) detection (MoCA 100% vs MMSE 78%). The MoCA it’s a multidomain brief tool characterized by a total of 30 items divided into assessments of cognitive function as visuospatial/executive, naming, attention, language, abstraction, delated recall, and orientation. Currently, the MoCA has multiple translations around the world, including Spanish ( www.mocaorg.com ). However, considering the importance of language and verbal fluency in the test, the cultural and linguistic diversity of Spanish-speaking LAC countries makes it difficult to know its true usefulness by using a single version and it is necessary to explore the process used in the various validation studies in the region. Therefore, the aim of this article is to systematically review the adaptations of the MoCA in Spanish-speaking LAC countries as a cognitive screening test for MCI and dementia assessment according to education-level. We also analyze and explore the process of translation and validation in these studies. Results Search results Thirteen articles reporting the validation of the MoCA in different LAC populations were identified. The selection process is presented in Fig. 1 . Just one article was excluded for different types of publication. Finally, 12 publications were selected for analysis. Of these, four were from Colombia ( 17 – 20 ), two from Chile ( 21 , 22 ), two from Ecuador ( 23 , 24 ), two from Argentina ( 25 , 26 ), one from Mexico ( 27 ), and one from Cuba ( 28 ). One publication assessed only control participants ( 17 ), three publications assessed patients with both controls and Mild Cognitive Impairment (MCI) ( 23 , 24 , 26 ), and finally, eight compared the performance of control groups, patients with MCI, and patients with dementia ( 18 – 22 , 25 , 27 , 28 ). Only 5 studies described the neuropsychological battery used. Three publications reported the use of imaging for the final diagnosis. No study reported the use of biomarkers. Table 1 shows all the publications identified. Adapted versions of MoCA Among all the selected studies, only two reported adaptations to the original version ( 22 , 25 ). One study described language adaptations involving minor lexical substitutions ( 22 ). In contrast, just one study meticulously documented the alterations, providing a cultural context and word usage frequency rationale ( 25 ). Moreover, one study contemplated instrument adaptation ( 18 ); however, following a consensus among specialists, it was deemed unnecessary. The memory domain was the sole area where adaptations were recorded. Out of these studies, only one achieved a moderately acceptable rating for translation and cultural adaptation, as reflected in an MTRQ and MCAQ score of 2a ( 25 ). Adaptations and translations report assessment is presented in Table 2 . Adaptations process assessment Only five studies report at least one step of the translation process before the administration of the test ( 18 , 20 – 22 , 25 ). Most of the studies report the involvement of the original author. On the other hand, professional translators; pilot testing and health professionals’ involvement were reported only by one study respectively ( 18 , 25 ). Finally, only two studies reported cultural adaptation (Table 3 ). Table 3 Adaptations and translation process assessment Table 2. Adaptations and translation report assessment Study MoCA’s Version Authorization Specific adaptations Justification Domains MTRQ Score MCAR Score Gómez et al. MoCA-S** NR NR NR None 0 0 Pereira-Manrique et al. MoCA-S + The authors agreed that it was not necessary A team of specialists agreed that the indications were clear with explicit and simple tests. None 1 0 Gil et al. MoCA-S NR NR NR None 0 0 Pedraza et. al. MoCA-S + NR NR None 0 0 Aguilar-Navarro et al. MoCA-S** NR NR NR None 0 0 González et. al. MoCA* - NR NR None 0 0 Delgado et al. MoCA-S NR Adaptations to the Chilean language by means of minor lexical substitutions Not specified Not specified 0 1 Serrano et al. MoCA-A + "rostro" to "cara" (face), "seda" (silk) to "terciopelo" (velvet) and "clavel" (carnation) to "margarita" (daysi). Based on the Argentinean culture, considering the category and frequency of the linguistic equivalents. Memory 2a 2a Bello-Lepe et al. MoCA-S + NR NR None 0 0 Rodríguez et. al. MoCA-S NR NR NR None 0 0 Vázquez et al. MoCA* NR NR NR None 0 0 Matovelle et al. MoCA-S - NR NR None 0 0 *Not specified by the authors **Version 7.0 NR: Not reported by the authors Study Back translation Cultural adaptation Professional translators Health professional involvement Involvement of the original author Pilot testing Gómez et al. Pereira et al. ⎫ ⎫ ⎫ Gil et al. Pedraza et. al. ⎫ Aguilar-Navarro et al. González et. al. Delgado et al. ⎫ Serrano et al. ⎫ ⎫ ⎫ Bello-Lepe et al. ⎫ Rodríguez et. al. Vázquez et al. Matovelle et al. Table 4 . Psychometric properties of MoCA for early dementia detection in Spanish-speaking LAC older adults MoCA Content validity Internal consistency Criterion validity Construct validity Agreement Reliability Diagnostic accuracy Floor/ceiling effect Interpretability Aguilar-Navarro, Mexico, 2018 - + + + ND ND + ND + Bello-Lepe, Chile, 2021 - + + + ND ND + ND + Delgado, Chile, 2019 - + + + ND ND + ND + Gil, Colombia, 2014 - + + + ND ND + ND + Gomez, Colombia, 2012 - ND ND ND + + ND ND ND Gonzales-Palau, Argentina, 2018 - ND + ND ND ND + ND + Matovelle, Ecuador, 2013 - ND ND + ND ND ND ND + Pedraza, 2016 - + + + + + + ND + Pereira-Manrique 2013 ?*** ND ? + ND ND + ND + Rodriguez-Lopez, Cuba, 2020 - ND ND ND ND ND + ND + Serrano, Argentina, 2020 - + + + ND ND + ND + Vasquez, Ecuador, 2022 - ND ND ND ND ND + ND + *+: positive; **-: negative: ND: no data available; ***? : indeterminate Psychometric properties report Assessment of the psychometric properties of all the studies is presented in Table 4 . The evaluation criteria for studies are shown in Supplementary Table 1 . Content Validity Of all the studies, only one study mentioned a description of the process where the MoCA test was evaluated by a group of experts ( 18 ). However, there was no more specific explanation of the process and was classified as indeterminate. Internal Consistency Half of the studies reported a Cronbach’s alpha of > 0.7 and none of the studies managed to rise above 0.9 which indicates a great internal consistency ( 19 – 22 , 25 , 27 ). Criterion validity Seven studies received a positive score ( 19 – 22 , 25 – 27 ). On the other hand, four studies did not report sufficient data to determine a final score. Only one study was classified as indeterminate( 18 ). Construct validity Four studies did not report data necessary to evaluate this validity ( 17 , 23 , 26 , 28 ). The rest of the studies received a positive rating for the assessment of this characteristic. Reproducibility Only two studies report adequate data on both agreement and reliability ( 17 , 20 ) Diagnostic accuracy Two studies presented data not available for this characteristic ( 17 , 24 ) Floor/Ceiling effect All studies failed to provide the data necessary to evaluate this characteristic. Interpretability Only one study did not compare different groups to evaluate the results of the MoCA test ( 17 ) Discussion This study summarizes the reported translation and cultural adaptation procedures of the stated 12 publications and successfully identifies which of these publications reported procedures in sufficient detail for potential adapters to be able to replicate the process through the use of the MTRQ and the MCAR (Table 2). Notably, only a single study ( 25 ) reached moderate score on MTRQ and MCAR scales. It is important to acknowledge that adapters of each non-English version of the MoCA may have translated the assessment and culturally adapted questions and not mentioned it in their publications, resulting in a score of 1 or 0. Regarding specific adaptations, only Serrano et al. (2020)( 25 ) reported specific adaptations in the memory domain based on the Argentinean culture, considering the category and frequency of the linguistic equivalents. All of the studies evaluating low-educational level participants reported that education level biased the results, particularly on the MoCA performed in Colombia ( 17 – 20 ). In this sense, studies using the MoCA in populations of Brazilian ( 29 , 30 ), Turkish ( 15 ), and Chinese ( 31 ) origin have reported the influence of education level on the MoCA cut-off points. A systematic review of the cultural validity of the MoCA ( 32 ) and a critical review of the brief cognitive screening (BCS) tools for older adults with low levels of education ( 33 ) suggest different cut-off points of the MoCA according to education level. The principal cognitive domain with significant floor effect in the Brazilian study was attention, which requires the individual to subtract backwards by 7 from 100, the majority of patients failed by 5 subtractions. Similar results were found for the repetition, verbal fluency, and abstraction subtests ( 34 ), meanwhile in a sample of patients from the Andean region of Colombia, where the average education level was 4.8 years and 8% were illiterate, the MoCA subtests least biased by education were orientation, delayed recall, and repetition. Additionally, the Trail Making Part B subtest was correctly performed by only 37% of those with an elementary-level education, less than 30% of those with an elementary-level education and 7% of illiterate individuals were able to correctly complete the cube drawing ( 17 ). The results showed a wide range of suggested cutoffs for MCI cross-culturally, with variability in levels of sensitivity and specificity ranging from low to high. Poor methodological rigor appears to have affected the reported accuracy and validity of the MoCA. The predominant domains for assessing the low educational level population are memory, orientation, visuospatial function, language, and verbal fluency because these components do not require reading and writing skills, which might contribute to reducing dementia’s overdiagnosis and rate of false positives ( 35 , 36 ). A major problem with BCS tools that use orientation is associated with the possibility of detecting dementia in early or moderate stages, but not MCI ( 11 , 37 ). On the other hand, BCTs that include executive functions have better psychometric properties ( 12 ), particularly in subcortical dementia such as Parkinson’s disease dementia, dementia with Lewy bodies ( 38 ), vascular dementia ( 39 ) cognitive impairment associated with multiple sclerosis ( 40 ); and cortical dementia, for example, behavioral variant frontotemporal dementia ( 41 , 42 ) and language variant primary progressive aphasia ( 38 ). Some studies suggest an early decline in conflictive instructions and motor inhibitory control in patients with prodromal Alzheimer’s disease ( 43 , 44 ) and recently other studies suggest that executive functions’ deficits are a key feature of the MCI phenotype linked to risk of progression to dementia in the Alzheimer’s clinical syndrome, predicting 63% of the variance of the conversion ( 45 , 46 ). These findings are consistent who support that category generation should be included in cognitive composites to predict cognitive decline ( 47 , 48 ). However, a failure in category verbal fluency may be indicative of language impairment ( 49 ). The high prevalence of lower educational achievement and socioeconomic disparities in LAC could explain the lowest performance of low-educated individuals on neuropsychological tests and contribute to misdiagnosis ( 50 , 51 ). In these population, the difficulties of employing diagnostic batteries requires cultural adaptation of neuropsychological instruments considering cognitive skills predominantly used in the daily context of life is essential to understanding the cognitive skills of learning and information management, and, consequently, to identifying pathologic cognitive impairment ( 52 ). The process of transcultural adaptation of cognitive screening instruments involves the development of versions of an assessment instrument that are equivalent to the original, but at the same time, linguistically and culturally adapted to a different context than the original ( 53 ). The MoCA basic has been proposed as an alternative for participants with low education but only has validations in Thai, English, Chinese and French languages ( 54 ). A major strength of this study is that it is the first systematic review of the MoCA’s adaptation and validation to screen MCI and dementia in LAC countries reporting the MoCA’s influenced by demographic variables, particularly education, so is important to take into account when interpreting the suggested cutoff points in order to improve diagnostic accuracy. Future studies should investigate the utility of the MoCA basic in low-educated populations. Therefore, the published systematic review addresses the BCS topic for cognitive impairment does not comprise publications conducted in the Spanish language or indexed in databases such as LILACS. Another strength is the inclusion criteria and detailed evaluation of the rates of diagnostic accuracy, an observation made in other publications. Limitations of this review include the lack of meta-analysis due to the quality of the studies with only one of the included studies rated as “moderate”. The main methodological issues with the studies included lack of sample size justifications and unclear criteria for differentiating between. Moreover, although some studies included participants with illiteracy, there was a lack of standardized criteria for definition across the studies. A review of each study is presented in the Supplementary Table 2 . The quality assessment ratings may also be subject to individual bias. Steps were taken to minimize bias, such as the addition of a second rater. Further efforts should consider the development of culturally adjusted screening tools that consider individuals with no formal education and illiterate populations whose prevalence increases in older age groups. This systematic review highlights the necessity for cross-cultural considerations when using the MoCA in Spanish-speaking LAC populations for screening. Appropriate cutoffs and point adjustments for education are suggested when administering the test in populations with low educational backgrounds. Methods Eligibility criteria Validation studies or cultural adaptations of MoCA, studies conducted in institutions located in LAC involving Spanish-speaking participants, publications where psychometric measures were available; and MoCA was compared with gold-standard diagnostic criteria, were considered for inclusion. All types of dementia were considered. Letters, editorials, conference presentations, and these were excluded. Studies where a different type of MoCA than the original was applied (MoCA Hearing Impairment, MoCA Blind, MoCA telephone, MoCA Audiovisual) and where MoCA was used as a screening method for cognitive impairment in secondary mental illness, traumatic brain injury, or cerebrovascular disorder were excluded. Information sources On 10/10/2023, we conducted a systematic literature electronic search in the following databases: PsycInfo, Medline, Scopus, LILACS, SciELO, ScienceDirect, Web of Science and Google Scholar. Search strategy Tow authors (DBP and ANC) independently searched for articles based on the following terms in English: (Dementia) AND (Montreal Cognitive Assessment) AND (Screening OR questionnaires OR brief cognitive screening OR validity) AND "Latin America" OR "Hispanic American" OR "South America" OR "Caribbean" OR "Latinos" OR "Mexico" OR "Colombia" OR "Argentina" OR "Chile" OR "Peru" OR "Bolivia" OR "Ecuador" OR "Paraguay" OR "Uruguay" OR "Venezuela" OR "Costa Rica" OR "El Salvador" OR "Guatemala" OR "Honduras" OR "Nicaragua" OR "Panama" OR "Cuba" OR "Puerto Rico" OR "Dominican Republic"). Then, the two authors performed a search for the same terms in Spanish. No filters in dates were applied. Every step was taken considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Selection process For selection studies, all the results from each database were exported to Rayyan ( https://www.rayyan.ai/ ) where duplicates were removed. Three authors (DBP, EMM and GLSO) identified studies independently by title and abstract related to the validation of the Montreal Cognitive Assessment in LAC countries. Then, the full texts of relevant studies were searched and selected according to eligibility criteria. Data collection process and data items Subsequently, three authors (GLSO, LS, and ADM) reviewed each selected study and, using a previously approved form, extracted data from the pre-defined variables of interest. General study data, methodological information, the version of MoCA used, and descriptions of adaptations were extracted. Additionally, the translation and adaptation quality, as well as the process, were assessed. Finally, four authors (NC, GSLO, LS and ADM) collected psychometric data from each study. Quality of translation and cultural adaptation report assessment For evaluating the quality of translation and cultural adaptation reports, we will utilize the Manchester Translation Report Questionnaire (MTRQ) and the Manchester Cultural Adaptation Questionnaire (MCAQ). These seven-point scales, developed by the Center for Primary Care Research at the University of Manchester ( 55 ), provide a quantitative assessment of the quality of procedures reported in the translation and cultural adaptation of neuropsychological evaluations. Quality of translation process assessment Given the absence of a universally agreed-upon method for assessing the versioning process of psychometric instruments, we utilized the approach adapted from Cova et al. ( 56 ) to appraise the quality of the process as detailed in each publication. Study risk of bias assessment The quality of the studies included in this analysis was evaluated based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) version 2. Three independent reviewers (GLSO, ADM and LS) applied the checklist of QUADAS-2 in every study. Declarations Competing interests The authors declare no competing interests. Acknowledgements DBP and NC conceived the study. DBC, NC, and RM designed the study. DBP and ANC designed the search strategy. EMM, ADM, GLSO and LS collected data. DBP, GLSO and EMM organized the database. DBP, RM and NC wrote the first draft of the manuscript. DBP, NC, RM and ANC wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the final version. References Nichols, E., et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health . 7 , e105–e125 (2022). Kalaria, R. 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Alzheimer's Research & Therapy. 14 , 11–16 (2022). Peter, J., et al. Category and design fluency in mild cognitive impairment: Performance, strategy use, and neural correlates. Neuropsychologia . 93 , 21–29 (2016). Giacominelli, C., Bertolucci, P. H. F., & Pereira, F. V. Verbal fluency fruits as a predictor of Alzheimer’s Disease progression in brazilian portuguese speakers. 7 , 1–6 (2017). Alegret, M., et al. The role of verb fluency in the detection of early cognitive impairment in Alzheimer’s Disease. Journal of Alzheimer's Disease . 62 , 611–619 (2018). Ortega, L. V., Aprahamian, I., Martinelli, J. E., Cecchini, M. A., Cação, J. de C., & Yassuda, M. S. Diagnostic accuracy of usual cognitive screening tests versus appropriate tests for lower education to identify Alzheimer Disease. Journal of Geriatric Psychiatry and Neurology. 34 , 222–231 (2021). Lopera, F., et al. A task force for diagnosis and treatment of people with Alzheimer’s disease in Latin America. Frontiers in Neurology . 14 , 1198869 (2023). Rosselli, M., Uribe, I. V., Ahne, E., & Shihadeh, L. Culture, ethnicity, and level of education in Alzheimer’s Disease. Neurotherapeutics . 19, 26–54 (2022). Arafat, S., Chowdhury, H., Qusar, M., & Hafez, M. Cross cultural adaptation and psychometric validation of research instruments: a methodological review. Journal of Behavioral Health . 5 , 129-136 (2016). Julayanont, P., et al. The Montreal Cognitive Assessment-Basic: a screening tool for mild cognitive impairment in illiterate and low-educated elderly adults. Journal of the American Geriatrics Society. 63 , 2550–2554 (2015). Landis, J. R., & Koch, G. G. The measurement of observer agreement for categorical data. Biometrics. 33 , 159-174 (1977). Cova, I., Nicotra, A., Maestri, G., Canevelli, M., Pantoni, L., & Pomati, S. Translations and cultural adaptations of the Montreal Cognitive Assessment: a systematic and qualitative review. Neurological Sciences . 43 , 113–124 (2022). Tables Table 1. Characteristics of selected studies Study Study design Country Year of publication Population age Average Education Level (years) N of participants Evaluated groups Gómez et al. Cross sectional study Colombia 2012 65 to 74 years 4.8 150 Controls Pereira-Manrique et al. Psychometric study of technological development. Colombia 2013 >65 years NR 226 Controls, MCI, Dementia Gil et al. Validation study Colombia 2014 >65 years 12 193 Controls, MCI, Dementia Pedraza et. al. Cross sectional study Colombia 2016 >50 years 6 1174 Controls, MCI, Dementia Aguilar-Navarro et al. Cross sectional validation study México 2018 >60 years 12,4 ± 3,7 10,0 ± 5,6 9,5 ± 5,8 168 Controls, MCI, Dementia González et. al. Cross sectional validation study Argentina 2018 >60 years 13,64 ± 3,69 12,77 ± 4,06 269 Controls, MCI Delgado et.al. Cross sectional validation study Chile 2019 >60 years 10,8 ± 4,4 172 Controls, MCI, Dementia Serrano et.al. Cross sectional validation study Argentina 2020 >60 years 10.34 399 Controls, MCI, Dementia Bello-Lepe et.al. Cross sectional study Chile 2020 NR NR 226 Controls, MCI, Dementia Rodríguez et. al. Cross sectional study Cuba 2020 >55 years 13,3 ± 3,2 9,4 ± 2,9 13,5 ± 4,1 133 Controls, MCI, Dementia Vázquez et al. Validation study Ecuador 2022 >65 years NR 93 Controls, MCI Matovelle et al. Cross sectional study Ecuador 2023 >60 years NR 200 Controls, MCI NR: Not reported Table 2. Adaptations and translation report assessment Study MoCA’s Version Authorization Specific adaptations Justification Domains MTRQ Score MCAR Score Gómez et al. MoCA-S** NR NR NR None 0 0 Pereira-Manrique et al. MoCA-S + The authors agreed that it was not necessary A team of specialists agreed that the indications were clear with explicit and simple tests. None 1 0 Gil et al. MoCA-S NR NR NR None 0 0 Pedraza et. al. MoCA-S + NR NR None 0 0 Aguilar-Navarro et al. MoCA-S** NR NR NR None 0 0 González et. al. MoCA* - NR NR None 0 0 Delgado et al. MoCA-S NR Adaptations to the Chilean language by means of minor lexical substitutions Not specified Not specified 0 1 Serrano et al. MoCA-A + "rostro" to "cara" (face), "seda" (silk) to "terciopelo" (velvet) and "clavel" (carnation) to "margarita" (daysi). Based on the Argentinean culture, considering the category and frequency of the linguistic equivalents. Memory 2a 2a Bello-Lepe et al. MoCA-S + NR NR None 0 0 Rodríguez et. al. MoCA-S NR NR NR None 0 0 Vázquez et al. MoCA* NR NR NR None 0 0 Matovelle et al. MoCA-S - NR NR None 0 0 *Not specified by the authors **Version 7.0 NR: Not reported by the authors Table 3. Adaptations and translation process assessment Study Back translation Cultural adaptation Professional translators Health professional involvement Involvement of the original author Pilot testing Gómez et al. Pereira et al. ✓ ✓ ✓ Gil et al. Pedraza et. al. ✓ Aguilar-Navarro et al. González et. al. Delgado et al. ✓ Serrano et al. ✓ ✓ ✓ Bello-Lepe et al. ✓ Rodríguez et. al. Vázquez et al. Matovelle et al. Table 4. Psychometric properties of MoCA for early dementia detection in Spanish-speaking LAC older adults MoCA Content validity Internal consistency Criterion validity Construct validity Agreement Reliability Diagnostic accuracy Floor/ceiling effect Interpretability Aguilar-Navarro, Mexico, 2018 - + + + ND ND + ND + Bello-Lepe, Chile, 2021 - + + + ND ND + ND + Delgado, Chile, 2019 - + + + ND ND + ND + Gil, Colombia, 2014 - + + + ND ND + ND + Gomez, Colombia, 2012 - ND ND ND + + ND ND ND Gonzales-Palau, Argentina, 2018 - ND + ND ND ND + ND + Matovelle, Ecuador, 2013 - ND ND + ND ND ND ND + Pedraza, 2016 - + + + + + + ND + Pereira-Manrique 2013 ?*** ND ? + ND ND + ND + Rodriguez-Lopez, Cuba, 2020 - ND ND ND ND ND + ND + Serrano, Argentina, 2020 - + + + ND ND + ND + Vasquez, Ecuador, 2022 - ND ND ND ND ND + ND + *+: positive; **-: negative: ND: no data available; ***? : indeterminate Additional Declarations There is NO Competing Interest. 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Sáenz Orihuea","email":"","orcid":"","institution":"Universidad Ricardo Palma","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gianinna","middleName":"L. Sáenz","lastName":"Orihuea","suffix":""},{"id":274073528,"identity":"68bb017f-7fb8-4a94-a15f-a3920ddb36c9","order_by":4,"name":"Enrique Moncada Mapelli","email":"","orcid":"","institution":"Universidad Científica del Sur","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Enrique","middleName":"Moncada","lastName":"Mapelli","suffix":""},{"id":274073529,"identity":"4e9193f7-2e43-49dc-8b64-fce9d7b4055c","order_by":5,"name":"Leslie Salazar","email":"","orcid":"","institution":"Universidad San Martín de Porres","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Leslie","middleName":"","lastName":"Salazar","suffix":""},{"id":274073530,"identity":"05618e25-767b-4e3e-949f-87f770a82a8e","order_by":6,"name":"Rosa Montesinos","email":"","orcid":"","institution":"Peruvian Institute of Neurosciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rosa","middleName":"","lastName":"Montesinos","suffix":""},{"id":274073531,"identity":"3d703cf6-d49b-4012-8a99-04e89b9f7a3d","order_by":7,"name":"Nilton Custodio","email":"","orcid":"","institution":"Peruvian Institute of Neurosciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nilton","middleName":"","lastName":"Custodio","suffix":""}],"badges":[],"createdAt":"2024-02-02 04:45:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3919583/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3919583/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51473826,"identity":"d9364c56-088e-47b7-8c8a-d00bddd58788","added_by":"auto","created_at":"2024-02-22 08:47:41","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1002501,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of the study selection process\u003c/p\u003e\n\u003cp\u003e*Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers).\u003c/p\u003e\n\u003cp\u003e**If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools.\u003c/p\u003e\n\u003cp\u003eFrom: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3919583/v1/e38a257391e7d0ad62b221fd.jpg"},{"id":51473583,"identity":"42c74240-be6c-4477-a717-f920f11033b3","added_by":"auto","created_at":"2024-02-22 08:39:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":356740,"visible":true,"origin":"","legend":"\u003cp\u003eLatin America and the Caribbean distribution of different validation studies of the Montreal Cognitive Assessment (MoCA) test.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-3919583/v1/4307f08a129a49a6b024f8cd.png"},{"id":69462034,"identity":"617954fa-bd58-48f5-9043-6fa3aab7b4e6","added_by":"auto","created_at":"2024-11-20 14:58:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2601027,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3919583/v1/0f7061c3-1b38-48ed-bf22-128ddb48a160.pdf"},{"id":51473584,"identity":"f3f7379c-d127-4ca1-93b4-8243e28feb05","added_by":"auto","created_at":"2024-02-22 08:39:41","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":20662,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"Supplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-3919583/v1/c206b63f739fb22dae323fcc.docx"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e Competing Interest.","formattedTitle":"The Montreal Cognitive Assessment in Spanish-speaking countries in Latin America and the Caribbean: A Systematic Review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe global prevalence of individuals living with dementia is anticipated to surge from 57.4% to 152.8\u0026nbsp;million by 2050 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). This rise in dementia cases will disproportionately impact Low- and Middle-Income Countries (LMICs), primarily due to their populations aging. Already 60% of individuals with dementia live in LMICs, and this figure is projected to elevate to 71% by 2050 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). This comes at a high societal burden and economic costs for affected healthcare systems and societies, for which screening for early diagnosis of mild cognitive impairment and dementia is crucial.\u003c/p\u003e \u003cp\u003eMost of the currently used brief cognitive screening (BCT) tools in Latin America and the Caribbean (LAC) were developed and validated in high income countries where higher levels of education are more prevalent. Considering that low levels of education are a risk factor for developing cognitive impairment (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and that health systems in LAC countries are inefficient, it is important to develop timely diagnostic strategies for this vulnerable population (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). An accurate diagnosis of dementia requires a reliable neuropsychological assessment (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) and the cognitive assessment tools are commonly used for screening impairment, differential diagnosis, determining disease severity, as monitoring disease progression in patients (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). On this sense, valid tests are needed for assessing individuals across a wide range of cultures and education (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This is particularly a challenge in LAC countries, where the largest and most challenging socio-economic inequality in the world are prevail. In this region, education systems reflect the highly unequal societies in which they are located (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBCT tools not adapted to age and schooling due to the lack of consciousness of psychometric characteristics constitute the first barrier to an accurate diagnosis, as the design of them are not low-educated specific, for example the reading, writing or copy of geometric figures (10,11). Similarly, the adaptation of non-culturally develop cognitive test could be challenging in some populations (i.e., indigenous participants), thus, culture-free items must be developed. Hence inequity to reach out neurocognitive diagnosis has not been completely solved.\u003c/p\u003e \u003cp\u003eThe Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most popular cognitive assessment tools worldwide (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Ellison et al. (2022) in their global inter-societal Delphi consensus for outcomes measurements for Alzheimer\u0026rsquo;s disease, through a strong consensus, recommended the MoCA and the MMSE for the assessment of memory and overall cognitive functioning in mild and moderate disease (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Still, they have been shown to have a significant bias related to educational level (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe MoCA developed by Nasreddine et.al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) has demonstrated to be more sensitive than MMSE for Mild Cognitive Impairment (MCI) detection (MoCA 90% vs MMSE 18%), and for mild Alzheimer\u0026rsquo;s disease (AD) detection (MoCA 100% vs MMSE 78%). The MoCA it\u0026rsquo;s a multidomain brief tool characterized by a total of 30 items divided into assessments of cognitive function as visuospatial/executive, naming, attention, language, abstraction, delated recall, and orientation. Currently, the MoCA has multiple translations around the world, including Spanish (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"https://orcid.org/0000-0002-8025-3272\" target=\"_blank\"\u003ewww.mocaorg.com\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.mocaorg.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). However, considering the importance of language and verbal fluency in the test, the cultural and linguistic diversity of Spanish-speaking LAC countries makes it difficult to know its true usefulness by using a single version and it is necessary to explore the process used in the various validation studies in the region.\u003c/p\u003e \u003cp\u003eTherefore, the aim of this article is to systematically review the adaptations of the MoCA in Spanish-speaking LAC countries as a cognitive screening test for MCI and dementia assessment according to education-level. We also analyze and explore the process of translation and validation in these studies.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSearch results\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThirteen articles reporting the validation of the MoCA in different LAC populations were identified. The selection process is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Just one article was excluded for different types of publication. Finally, 12 publications were selected for analysis. Of these, four were from Colombia (\u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), two from Chile (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), two from Ecuador (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), two from Argentina (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), one from Mexico (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), and one from Cuba (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). One publication assessed only control participants (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), three publications assessed patients with both controls and Mild Cognitive Impairment (MCI) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and finally, eight compared the performance of control groups, patients with MCI, and patients with dementia (\u003cspan additionalcitationids=\"CR19 CR20 CR21\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Only 5 studies described the neuropsychological battery used. Three publications reported the use of imaging for the final diagnosis. No study reported the use of biomarkers. \u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e shows all the publications identified.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eAdapted versions of MoCA\u003c/h2\u003e \u003cp\u003eAmong all the selected studies, only two reported adaptations to the original version (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). One study described language adaptations involving minor lexical substitutions (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In contrast, just one study meticulously documented the alterations, providing a cultural context and word usage frequency rationale (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Moreover, one study contemplated instrument adaptation (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e); however, following a consensus among specialists, it was deemed unnecessary. The memory domain was the sole area where adaptations were recorded. Out of these studies, only one achieved a moderately acceptable rating for translation and cultural adaptation, as reflected in an MTRQ and MCAQ score of 2a (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Adaptations and translations report assessment is presented in \u003cb\u003eTable\u0026nbsp;2\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eAdaptations process assessment\u003c/h2\u003e \u003cp\u003eOnly five studies report at least one step of the translation process before the administration of the test (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Most of the studies report the involvement of the original author. On the other hand, professional translators; pilot testing and health professionals\u0026rsquo; involvement were reported only by one study respectively (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Finally, only two studies reported cultural adaptation (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAdaptations and translation process assessment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;2. Adaptations and translation report assessment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMoCA\u0026rsquo;s Version\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eAuthorization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSpecific adaptations\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eJustification\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eDomains\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eMTRQ Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eMCAR Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u0026oacute;mez et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePereira-Manrique et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eThe authors agreed that it was not necessary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eA team of specialists agreed that the indications were clear with explicit and simple tests.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGil et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePedraza et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAguilar-Navarro et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGonz\u0026aacute;lez et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelgado et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdaptations to the Chilean language by means of minor lexical substitutions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerrano et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"rostro\" to \"cara\" (face), \"seda\" (silk) to \"terciopelo\" (velvet) and \"clavel\" (carnation) to \"margarita\" (daysi).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBased on the Argentinean culture, considering the category and frequency of the linguistic equivalents.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2a\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBello-Lepe et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRodr\u0026iacute;guez et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eV\u0026aacute;zquez et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatovelle et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoCA-S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e*Not specified by the authors **Version 7.0 NR: Not reported by the authors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBack translation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCultural adaptation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProfessional translators\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHealth professional involvement\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInvolvement of the original author\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePilot testing\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u0026oacute;mez et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePereira et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGil et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePedraza et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAguilar-Navarro et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGonz\u0026aacute;lez et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelgado et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerrano et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBello-Lepe et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e⎫\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRodr\u0026iacute;guez et. al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eV\u0026aacute;zquez et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatovelle et al.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Psychometric properties of MoCA for early dementia detection in Spanish-speaking LAC older adults\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMoCA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContent validity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInternal consistency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCriterion validity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConstruct validity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAgreement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eReliability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eDiagnostic accuracy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eFloor/ceiling effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eInterpretability\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAguilar-Navarro, Mexico, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBello-Lepe, Chile, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelgado, Chile, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGil, Colombia, 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGomez, Colombia, 2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGonzales-Palau, Argentina, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatovelle, Ecuador, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePedraza, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePereira-Manrique 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e?***\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRodriguez-Lopez, Cuba, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerrano, Argentina, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVasquez, Ecuador, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eND\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e+\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e*+: positive; **-: negative: ND: no data available; ***? : indeterminate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003ePsychometric properties report\u003c/h2\u003e \u003cp\u003eAssessment of the psychometric properties of all the studies is presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The evaluation criteria for studies are shown in \u003cb\u003eSupplementary Table\u0026nbsp;1\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eContent Validity\u003c/h2\u003e \u003cp\u003eOf all the studies, only one study mentioned a description of the process where the MoCA test was evaluated by a group of experts (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, there was no more specific explanation of the process and was classified as indeterminate.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eInternal Consistency\u003c/h2\u003e \u003cp\u003eHalf of the studies reported a Cronbach\u0026rsquo;s alpha of \u0026gt;\u0026thinsp;0.7 and none of the studies managed to rise above 0.9 which indicates a great internal consistency (\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eCriterion validity\u003c/h2\u003e \u003cp\u003eSeven studies received a positive score (\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). On the other hand, four studies did not report sufficient data to determine a final score. Only one study was classified as indeterminate(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003eConstruct validity\u003c/h2\u003e \u003cp\u003eFour studies did not report data necessary to evaluate this validity (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The rest of the studies received a positive rating for the assessment of this characteristic.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eReproducibility\u003c/h2\u003e \u003cp\u003eOnly two studies report adequate data on both agreement and reliability (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eDiagnostic accuracy\u003c/h2\u003e \u003cp\u003eTwo studies presented data not available for this characteristic (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eFloor/Ceiling effect\u003c/h2\u003e \u003cp\u003eAll studies failed to provide the data necessary to evaluate this characteristic.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eInterpretability\u003c/h2\u003e \u003cp\u003eOnly one study did not compare different groups to evaluate the results of the MoCA test (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study summarizes the reported translation and cultural adaptation procedures of the stated 12 publications and successfully identifies which of these publications reported procedures in sufficient detail for potential adapters to be able to replicate the process through the use of the MTRQ and the MCAR (Table\u0026nbsp;2). Notably, only a single study (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) reached moderate score on MTRQ and MCAR scales. It is important to acknowledge that adapters of each non-English version of the MoCA may have translated the assessment and culturally adapted questions and not mentioned it in their publications, resulting in a score of 1 or 0. Regarding specific adaptations, only Serrano et al. (2020)(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) reported specific adaptations in the memory domain based on the Argentinean culture, considering the category and frequency of the linguistic equivalents.\u003c/p\u003e \u003cp\u003eAll of the studies evaluating low-educational level participants reported that education level biased the results, particularly on the MoCA performed in Colombia (\u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In this sense, studies using the MoCA in populations of Brazilian (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), Turkish (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), and Chinese (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) origin have reported the influence of education level on the MoCA cut-off points. A systematic review of the cultural validity of the MoCA (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) and a critical review of the brief cognitive screening (BCS) tools for older adults with low levels of education (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) suggest different cut-off points of the MoCA according to education level. The principal cognitive domain with significant floor effect in the Brazilian study was attention, which requires the individual to subtract backwards by 7 from 100, the majority of patients failed by 5 subtractions. Similar results were found for the repetition, verbal fluency, and abstraction subtests (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), meanwhile in a sample of patients from the Andean region of Colombia, where the average education level was 4.8 years and 8% were illiterate, the MoCA subtests least biased by education were orientation, delayed recall, and repetition. Additionally, the Trail Making Part B subtest was correctly performed by only 37% of those with an elementary-level education, less than 30% of those with an elementary-level education and 7% of illiterate individuals were able to correctly complete the cube drawing (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results showed a wide range of suggested cutoffs for MCI cross-culturally, with variability in levels of sensitivity and specificity ranging from low to high. Poor methodological rigor appears to have affected the reported accuracy and validity of the MoCA. The predominant domains for assessing the low educational level population are memory, orientation, visuospatial function, language, and verbal fluency because these components do not require reading and writing skills, which might contribute to reducing dementia\u0026rsquo;s overdiagnosis and rate of false positives (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). A major problem with BCS tools that use orientation is associated with the possibility of detecting dementia in early or moderate stages, but not MCI (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). On the other hand, BCTs that include executive functions have better psychometric properties (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), particularly in subcortical dementia such as Parkinson\u0026rsquo;s disease dementia, dementia with Lewy bodies (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e), vascular dementia (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) cognitive impairment associated with multiple sclerosis (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e); and cortical dementia, for example, behavioral variant frontotemporal dementia (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e) and language variant primary progressive aphasia (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Some studies suggest an early decline in conflictive instructions and motor inhibitory control in patients with prodromal Alzheimer\u0026rsquo;s disease (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e) and recently other studies suggest that executive functions\u0026rsquo; deficits are a key feature of the MCI phenotype linked to risk of progression to dementia in the Alzheimer\u0026rsquo;s clinical syndrome, predicting 63% of the variance of the conversion (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). These findings are consistent who support that category generation should be included in cognitive composites to predict cognitive decline (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). However, a failure in category verbal fluency may be indicative of language impairment (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe high prevalence of lower educational achievement and socioeconomic disparities in LAC could explain the lowest performance of low-educated individuals on neuropsychological tests and contribute to misdiagnosis (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). In these population, the difficulties of employing diagnostic batteries requires cultural adaptation of neuropsychological instruments considering cognitive skills predominantly used in the daily context of life is essential to understanding the cognitive skills of learning and information management, and, consequently, to identifying pathologic cognitive impairment (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). The process of transcultural adaptation of cognitive screening instruments involves the development of versions of an assessment instrument that are equivalent to the original, but at the same time, linguistically and culturally adapted to a different context than the original (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e). The MoCA basic has been proposed as an alternative for participants with low education but only has validations in Thai, English, Chinese and French languages (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA major strength of this study is that it is the first systematic review of the MoCA\u0026rsquo;s adaptation and validation to screen MCI and dementia in LAC countries reporting the MoCA\u0026rsquo;s influenced by demographic variables, particularly education, so is important to take into account when interpreting the suggested cutoff points in order to improve diagnostic accuracy. Future studies should investigate the utility of the MoCA basic in low-educated populations. Therefore, the published systematic review addresses the BCS topic for cognitive impairment does not comprise publications conducted in the Spanish language or indexed in databases such as LILACS. Another strength is the inclusion criteria and detailed evaluation of the rates of diagnostic accuracy, an observation made in other publications.\u003c/p\u003e \u003cp\u003eLimitations of this review include the lack of meta-analysis due to the quality of the studies with only one of the included studies rated as \u0026ldquo;moderate\u0026rdquo;. The main methodological issues with the studies included lack of sample size justifications and unclear criteria for differentiating between. Moreover, although some studies included participants with illiteracy, there was a lack of standardized criteria for definition across the studies. A review of each study is presented in the \u003cb\u003eSupplementary Table\u0026nbsp;2\u003c/b\u003e. The quality assessment ratings may also be subject to individual bias. Steps were taken to minimize bias, such as the addition of a second rater. Further efforts should consider the development of culturally adjusted screening tools that consider individuals with no formal education and illiterate populations whose prevalence increases in older age groups.\u003c/p\u003e \u003cp\u003eThis systematic review highlights the necessity for cross-cultural considerations when using the MoCA in Spanish-speaking LAC populations for screening. Appropriate cutoffs and point adjustments for education are suggested when administering the test in populations with low educational backgrounds.\u003c/p\u003e "},{"header":"Methods","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eValidation studies or cultural adaptations of MoCA, studies conducted in institutions located in LAC involving Spanish-speaking participants, publications where psychometric measures were available; and MoCA was compared with gold-standard diagnostic criteria, were considered for inclusion. All types of dementia were considered. Letters, editorials, conference presentations, and these were excluded. Studies where a different type of MoCA than the original was applied (MoCA Hearing Impairment, MoCA Blind, MoCA telephone, MoCA Audiovisual) and where MoCA was used as a screening method for cognitive impairment in secondary mental illness, traumatic brain injury, or cerebrovascular disorder were excluded.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eInformation sources\u003c/h2\u003e \u003cp\u003eOn 10/10/2023, we conducted a systematic literature electronic search in the following databases: PsycInfo, Medline, Scopus, LILACS, SciELO, ScienceDirect, Web of Science and Google Scholar.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eSearch strategy\u003c/h2\u003e \u003cp\u003eTow authors (DBP and ANC) independently searched for articles based on the following terms in English: (Dementia) AND (Montreal Cognitive Assessment) AND (Screening OR questionnaires OR brief cognitive screening OR validity) AND \"Latin America\" OR \"Hispanic American\" OR \"South America\" OR \"Caribbean\" OR \"Latinos\" OR \"Mexico\" OR \"Colombia\" OR \"Argentina\" OR \"Chile\" OR \"Peru\" OR \"Bolivia\" OR \"Ecuador\" OR \"Paraguay\" OR \"Uruguay\" OR \"Venezuela\" OR \"Costa Rica\" OR \"El Salvador\" OR \"Guatemala\" OR \"Honduras\" OR \"Nicaragua\" OR \"Panama\" OR \"Cuba\" OR \"Puerto Rico\" OR \"Dominican Republic\"). Then, the two authors performed a search for the same terms in Spanish. No filters in dates were applied. Every step was taken considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eSelection process\u003c/h2\u003e \u003cp\u003eFor selection studies, all the results from each database were exported to Rayyan (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.rayyan.ai/\u003c/span\u003e\u003cspan address=\"https://www.rayyan.ai/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) where duplicates were removed. Three authors (DBP, EMM and GLSO) identified studies independently by title and abstract related to the validation of the Montreal Cognitive Assessment in LAC countries. Then, the full texts of relevant studies were searched and selected according to eligibility criteria.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eData collection process and data items\u003c/h2\u003e \u003cp\u003eSubsequently, three authors (GLSO, LS, and ADM) reviewed each selected study and, using a previously approved form, extracted data from the pre-defined variables of interest. General study data, methodological information, the version of MoCA used, and descriptions of adaptations were extracted. Additionally, the translation and adaptation quality, as well as the process, were assessed. Finally, four authors (NC, GSLO, LS and ADM) collected psychometric data from each study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eQuality of translation and cultural adaptation report assessment\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eFor evaluating the quality of translation and cultural adaptation reports, we will utilize the Manchester Translation Report Questionnaire (MTRQ) and the Manchester Cultural Adaptation Questionnaire (MCAQ). These seven-point scales, developed by the Center for Primary Care Research at the University of Manchester (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e), provide a quantitative assessment of the quality of procedures reported in the translation and cultural adaptation of neuropsychological evaluations.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eQuality of translation process assessment\u003c/h2\u003e \u003cp\u003eGiven the absence of a universally agreed-upon method for assessing the versioning process of psychometric instruments, we utilized the approach adapted from Cova et al. (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e) to appraise the quality of the process as detailed in each publication.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eStudy risk of bias assessment\u003c/h2\u003e \u003cp\u003eThe quality of the studies included in this analysis was evaluated based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) version 2. Three independent reviewers (GLSO, ADM and LS) applied the checklist of QUADAS-2 in every study.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eDBP and NC conceived the study. DBC, NC, and RM designed the study. DBP and ANC designed the search strategy. EMM, ADM, GLSO and LS collected data. DBP, GLSO and EMM organized the database. DBP, RM and NC wrote the first draft of the manuscript. DBP, NC, RM and ANC wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the final version.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNichols, E., et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. \u003cem\u003eLancet Public Health\u003c/em\u003e. \u003cstrong\u003e7\u003c/strong\u003e, e105\u0026ndash;e125 (2022). \u003c/li\u003e\n\u003cli\u003eKalaria, R. N., et al. Alzheimer\u0026apos;s disease and vascular dementia in developing countries: Prevalence, management, and risk factors. \u003cem\u003eLancet Neurol\u003c/em\u003e. \u003cstrong\u003e7\u003c/strong\u003e, 812\u0026ndash;826 (2008).\u003c/li\u003e\n\u003cli\u003eAlzheimer\u0026rsquo;s Disease International (ADI). 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Translations and cultural adaptations of the Montreal Cognitive Assessment: a systematic and qualitative review. \u003cem\u003eNeurological Sciences\u003c/em\u003e. \u003cstrong\u003e43\u003c/strong\u003e, 113\u0026ndash;124 (2022). \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" style=\"width: 87.4317%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Characteristics of selected studies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.459%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eYear of publication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePopulation age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAverage Education Level (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eN of participants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEvaluated groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eG\u0026oacute;mez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eColombia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e65 to 74 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePereira-Manrique et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003ePsychometric study of technological development.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eColombia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGil et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eValidation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eColombia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePedraza et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eColombia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAguilar-Navarro et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional validation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eM\u0026eacute;xico\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12,4 \u0026plusmn; 3,7\u003cbr\u003e\u0026nbsp;10,0 \u0026plusmn; 5,6\u003cbr\u003e\u0026nbsp;9,5 \u0026plusmn; 5,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGonz\u0026aacute;lez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional validation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eArgentina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13,64 \u0026plusmn; 3,69\u003cbr\u003e\u0026nbsp;12,77 \u0026plusmn; 4,06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDelgado et.al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional validation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eChile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10,8 \u0026plusmn; 4,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSerrano et.al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional validation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eArgentina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBello-Lepe et.al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eChile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRodr\u0026iacute;guez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCuba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;55 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13,3 \u0026plusmn; 3,2\u003c/p\u003e\n \u003cp\u003e9,4 \u0026plusmn; 2,9\u003c/p\u003e\n \u003cp\u003e13,5 \u0026plusmn; 4,1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI, Dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eV\u0026aacute;zquez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eValidation study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eEcuador\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMatovelle et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.6394%;\"\u003e\n \u003cp\u003eCross sectional study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eEcuador\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;60 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.459%;\"\u003e\n \u003cp\u003eControls, MCI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" style=\"width: 87.4317%;\"\u003e\n \u003cp\u003eNR: Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.459%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Adaptations and translation report assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMoCA\u0026rsquo;s Version\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAuthorization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSpecific adaptations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eJustification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDomains\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMTRQ Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMCAR Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eG\u0026oacute;mez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePereira-Manrique et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eThe authors agreed that it was not necessary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eA team of specialists agreed that the indications were clear with explicit and simple tests.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGil et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePedraza et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAguilar-Navarro et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGonz\u0026aacute;lez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDelgado et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAdaptations to the Chilean language by means of minor lexical substitutions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNot specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNot specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSerrano et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026quot;rostro\u0026quot; to \u0026quot;cara\u0026quot; (face), \u0026quot;seda\u0026quot; (silk) to \u0026quot;terciopelo\u0026quot; (velvet) and \u0026quot;clavel\u0026quot; (carnation) to \u0026quot;margarita\u0026quot; (daysi).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBased on the Argentinean culture, considering the category and frequency of the linguistic equivalents.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMemory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBello-Lepe et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRodr\u0026iacute;guez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eV\u0026aacute;zquez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMatovelle et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMoCA-S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\n \u003cp\u003e*Not specified by the authors **Version 7.0 NR: Not reported by the authors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Adaptations and translation process assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003eBack translation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCultural adaptation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfessional translators\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth professional involvement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement of the original author\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePilot testing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eG\u0026oacute;mez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003ePereira et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eGil et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003ePedraza et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eAguilar-Navarro et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eGonz\u0026aacute;lez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eDelgado et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eSerrano et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eBello-Lepe et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e✓\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eRodr\u0026iacute;guez et. al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eV\u0026aacute;zquez et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003eMatovelle et al.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.61855670103093%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.463917525773196%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003ePsychometric properties of MoCA for early dementia detection in Spanish-speaking LAC older adults\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMoCA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eContent validity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInternal consistency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCriterion validity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eConstruct validity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAgreement\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eReliability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiagnostic accuracy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFloor/ceiling effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInterpretability\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAguilar-Navarro, Mexico, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBello-Lepe, Chile, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDelgado, Chile, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGil, Colombia, 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eND\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGomez, 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\u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3919583/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3919583/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe worldwide prevalence of individuals living with dementia is on the rise and expected to reach 152.8 million people by 2050. This increase will affect disproportionately Low- and Middle Income Countries, which is already home to 60% of individuals living with dementia. Screening tools for early detection of mild cognitive impairment are crucial to provide patients with adequate diagnosis, timely interventions, and access to disease-modifying therapies. The Montreal Cognitive Assessment (MoCA) is one of the most widely used tests for cognitive assessment of first line, but its uniform application across Latin American and Caribbean (LAC) countries is questionable due to cultural and linguistic differences, a higher prevalence of low educational achievement and socioeconomical disparities. This systematic review for validation of the MoCA in Spanish-speaking LAC countries identified fourteen studies but only included twelve based on inclusion and exclusion criteria. We assessed the articles for cultural adaptation and translation reports using the Manchester Cultural Adaptation Questionnaire and the Manchester Translation Reporting Questionnaire. Only two studies reported significant adaptations to the original MoCA, with one study providing detailed cultural and lexical rationale. The adaptation process assessment revealed limited reporting on the translation steps involved, with few studies detailing the original author's involvement, professional translation, pilot testing, or healthcare professional input. This systematic review suggests the use of suitable cutoff scores, educational level-based scoring adjustments, and cultural awareness are key for adequate screening using the MoCA in LAC Spanish-speaking countries.\u003c/p\u003e\n\u003cp\u003ePROSPERO Study registration number: CRD42023465794.\u003c/p\u003e","manuscriptTitle":"The Montreal Cognitive Assessment in Spanish-speaking countries in Latin America and the Caribbean: A Systematic Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-22 08:39:36","doi":"10.21203/rs.3.rs-3919583/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"296771f8-f461-451b-80b8-aa959fa4d565","owner":[],"postedDate":"February 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":28888984,"name":"Health sciences/Neurology/Neurological disorders/Neurodegenerative diseases/Alzheimer's disease"},{"id":28888985,"name":"Health sciences/Neurology/Neurological disorders/Dementia/Alzheimer's disease"}],"tags":[],"updatedAt":"2024-11-20T14:50:33+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-22 08:39:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3919583","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3919583","identity":"rs-3919583","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}