Normative data for the MoCA - Language (MoCA-L): A brief screening tool for language disorders in neurodegenerative diseases

Background
Screening tools for global cognition such as the Mini-Mental State Examination and the Montreal Cognitive Assessment (MoCA) are often used to screen language skills, although they were not originally designedd for this purpose. To address this gap, we developed the MoCA - Language (MoCA-L), a brief screening tool for cognitive-linguistic disorders observed in primary progressive aphasia (PPA) and other neurodegenerative diseases with language issues. The MoCA-L comprises six subtests: conversation, picture naming, semantic knowledge, pseudowords and sentence repetition, sentence comprehension as well as a written picture description, for a total of 30 points. Validation data showed high test-retest and interrater reliability. Previous validation work demonstrated high test-retest and interrater reliability. The aim of this study is to present preliminary normative data for the MoCA-L in healthy controls (HC) and participants with PPA.

Methods
Eighty HC have been included in the ongoing normative study . Mean age is 67.9 years old with a mean education of 15.6 years. Ten participants with PPA (6 with logopenic PPA, 3 with semantic PPA and 1 with non-fluent/agrammatic PPA) were also included (mean age: 68.9, mean education: 12.4 years). Each participant was administered the MoCA and the MoCA-L. Descriptive statistics (means and standard deviations) were calculated for each subtest as well as for the total score.

Results
Performance on the MoCA-L was significantly correlated with the MoCA score (r=.78, p=.01). Healthy controls performed near ceiling, as expected on the MoCA-L, with a mean total score of 29.5 out of 30 (SD=0.7). Errors mostly occurred in the pseudowords and sentence repetition subtest. Performance varied widely among participants with PPA, with total scores ranging from 11 to 26 (mean=20.8; SD=5.1). In this clinical sample, the most impaired subtests were picture naming, pseudowords and sentence repetition and the written picture description. In the majority of PPA cases (80%) , the pattern of errors was congruent with original clinical diagnosis.

Conclusions
The MoCA-L is expected to provide healthcare professionals with a simple and rapid screening tool specifically designed to assess language deficits in neurocognitive disorders, thereby improving early diagnosis and clinical management. Normative data collection is ongoing, and future work will include larger samples, demographic adjustments, and validation in multiple languages, similar to the MoCA.