Adaptation and Validation of the Tamil (Sri Lanka) Version ofthe Montreal Cognitive Assessment

Pethirupillai Amal Dinesh Coonghe, Pushpa Fonseka, Sampasivamoorthy Sivayogan, Ajantha Keshavaraj, Rahul Malhotra, Truls Ostbye


The study aimed to develop the Tamil (Sri Lanka) version of the Montreal Cognitive Assessment (MoCA) and investigate its reliability and validity as a briefscreening tool for mild cognitive impairment (MCI). Tamil-speaking Sri Lankan elderly with normal cognition and MCI were recruited from a neurology clinic.Adaptation of the English MoCA to the Tamil (Sri Lanka) involved context-specific content modification and translation. The content validity, reliability, sensitivity,and specificity of the tool were evaluated. Study participants were 184 older adults, comprising 85 with normal cognition and 99 neurologist-diagnosed MCI.The tool had high internal consistency (Cronbach's alpha = 0.83). Receiver operating characteristic curve analyses showed an area under the curve of 0.87(95% CI = 0.83 - 0.91) for detecting MCI. The optimal cut-off score for detection of MCI was 23/24, yielded a sensitivity and specificity of 84.7% and 76.4%,respectively. The Tamil (Sri Lankan) version of the MoCA maintains its core diagnostic properties rendering it a valid and reliable tool for screening of MCIamong Tamil speaking Sri Lankan older adults.



Elderly, mild cognitive impairment, montreal cognitive assessment, Sri Lanka, Tamil

Full Text:



 1. Folstein MF, Folstein SE, Mchugh PR. " MINI-MENTAL STATE " A PRACTICAL METHOD FOR GRADING THE COGNITIVE STATE OF PATIENTS FOR THE CLINICIAN*. J gsychiaf Res [Internet]. 1975 [cited 2017 Jul 14];12:189–98. Available from:

&nbsp2. Nasreddine ZS, Phillips N a., Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–9.

&nbsp3. Lee J-Y, Dong Woo Lee, Cho S-J, Na DL, Hong Jin Jeon, Kim S-K, et al. Brief Screening for Mild Cognitive Impairment in Elderly Outpatient Clinic: Validation of the Korean Version of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol [Internet]. 2008;21(2):104–10. Available from:

&nbsp4. Yeung PY, Wong LL, Chan CC, Leung JLM, Yung CY. A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong. Hong Kong Med J. 2014;20(6):504–10.

&nbsp5. Karunaratne S, Hanwella R, De Silva V. Validation of the Sinhala version of the Montreal Cognitive Assessment in screening for dementia. Ceylon Med J. 2011;56(4):2–8.

&nbsp6. Department of Census and Statistics SL. Census of Population and Housing of Sri Lanka , 2012 Population by divisional secretariat division , sex. 2012;

&nbsp7. Tamil | Ethnologue [Internet]. [cited 2019 Feb 2]. Available from:

&nbsp8. UNESCO ND. UNESCO country programming document for Sri Lanka, 2013-2017; 2013 [Internet]. 2013 [cited 2017 Jul 25]. Available from:

&nbsp9. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, D.C., American Psychiatric Association, 2000. Text. 2000;2000.

&nbsp10. Streiner DL. A checklist for evaluating the usefulness of rating scales. Can J Psychiatry [Internet]. 1993 Mar [cited 2015 Apr 30];38(2):140–8. Available from:

&nbsp11. Abdollahimohammad A, Ja’afar R. Learning Style Scales: a valid and reliable questionnaire. J Educ Eval Health Prof [Internet]. 2014 Jan [cited 2015 Mar 28];11:22. Available from:

&nbsp12. Gil L, Vega JG, Ruiz de Sanchez C, Burgos FP. Validation of the Montreal Cognitive Assessment – Spanish Version test (MoCA-S) as a screening tool for mild cognitive impairment and mild dementia in Bogotá, Colombia. Alzheimer’s Dement [Internet]. 2013;9(4):P452–3. Available from:

&nbsp13. Yu J, Li J, Huang X. The Beijing version of the montreal cognitive assessment as a brief screening tool for mild cognitive impairment: a community-based study. BMC Psychiatry. 2012;12(1):156.



  • There are currently no refbacks.