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Evaluating the Cultural Validity of the Montreal Cognitive Assessment: A Comparison of Performance in Bengali and English tests in Bangladeshi adults with Parkinson's disease in East London.

Shahid, A. J.; Waters, S.; Singh, M.; Zirra, A.; Bhadra, E.; Camboe, E.; Huxford, B.; Haque, T.; Gallagher, D.; Boyle, T.; Budu, C.; Marshall, C. R.; Noyce, A. J.; DEY, K. C.

2026-02-19 neurology
10.64898/2026.02.18.26346549 medRxiv
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BackgroundThe Montreal Cognitive Assessment (MoCA) is a recommended brief screening tool to detect cognitive impairment in people with Parkinsons disease (PD). ObjectiveTo compare English and Bengali MoCA performance in Bangladeshi individuals with PD in East London. MethodsThis cross-sectional study involved participants completing both English and Bengali MoCA. Analyses included ANCOVA, paired and unpaired t-tests, and Bland-Altman methods in full and age-matched samples. ResultsFifty PD participants and 22 healthy controls (HC) were included in the full analysis. Both groups scored higher on Bengali than English MoCA (mean difference [~]4 points, p<0.001). Age-matched analyses (n= 29 PD and 22 HC) detected PD-control differences with the Bengali but not English version (p=0.02). Bengali scores aligned more closely with multidisciplinary assessments, though mean scores remained below normative cut-offs. ConclusionBengali MoCA improves detection of cognitive differences over English but still overestimates impairment, supporting the need for culturally adapted tools and population-specific cut-offs.

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