It is probably the most popular measure to screen for cognitive impairment and has been culturally validated in many countries. The scale assesses cognitive capacities with respect to orientation, registration, attention, recall, and language, as well as the ability to follow verbal and written commands. MMSE was originally developed in the United States in 1975 for dementia screening. Two widely used tools for assessing cognitive function are the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Hence, thorough neuropsychiatric assessment, including cognitive assessment, is essential to guiding rehabilitation efforts and appropriate medication regimens. ![]() Addressing post-TBI cognitive deficits is crucial as cognitive impairment is an important factor that affects rehabilitation outcomes. Especially problematic are impairments to relatively basic cognitive functions, such as attention and memory because these may cause or worsen additional deficits in executive function, communication, and other more complex processes. Deficits in attention, memory, and executive functioning are the most common neurocognitive consequences of TBI at all levels of severity. In particular, cognitive impairment due to TBI is a substantial source of morbidity for affected individuals, their family members, and communities at-large. Its sequelae include: changes in cognition, short term memory loss, attention deficit, mood disturbances, and personality changes – including impulsivity and irritability. ![]() An estimated 10 million people are affected annually with over 57 million people worldwide hospitalized with one or more TBI. Of all injuries, traumatic brain injury (TBI) is one of the most common causes of death and disability globally, and is expected to surpass many diseases as a major cause of death and disability by 2020. Both instruments require further validation studies to prove their predictive ability for screening cognitive impairment before they are considered suitable for clinical use. On the other hand, MMSE does not appear to be an appropriate tool in this patient group, but its positive correlations with MoCA and cFIM indicate similar theoretical concepts. With the exception of the language and memory items, MoCA is a valid and reliable instrument for cognitive impairment screening in Tanzania’s adult TBI population. Polychoric correlation between MMSE and MoCA was strong, positive and statistically significant ( r = 0.68, p = 0.001) correlation with the cognitive subscale of FIM indicated moderately positive relationships - MMSE ( r = 0.35, p = 0.001) and MoCA ( r = 0.43, p = 0.001). Factor loadings for most of the MMSE items were below 0.5 and internal consistency was medium (< 0.7). MoCA showed adequate factor loadings (values > 0.50 for all items except items 7 & 10) and adequate reliability (values > 0.70). Confirmatory factor analysis, reliability and external validity were evaluated. Our patient sample consisted of 192 adults with TBI who were admitted to Kilimanjaro Christian Medical Center (KCMC) in Tanzania. MethodsĪ cross-cultural adaptation committee participated in the translation and content validation process for both questionnaires. Our aim was to report the psychometric properties of the Swahili version of both scales amongst the TBI population in Tanzania. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are two commonly used instruments to measure cognitive impairment, and there have been a few studies reporting their use in post-TBI cognitive assessment. However, no such instrument has been validated in Tanzania’s TBI population. ![]() ![]() Addressing post-TBI cognitive deficits is crucial because they affect rehabilitation outcomes, but doing this requires valid and reliable cognitive assessment measures. Traumatic Brain Injury (TBI) is the most common cause of injury-related death and disability globally, and a common sequelae is cognitive impairment.
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