Objective: The study objectives were to 1) characterize scores on the Montreal Cognitive Assessment (MoCA) in patients with Parkinson’s disease (PD) from Latin America, 2) evaluate the clinical factors associated with MoCA scores in this population, and 3) examine differences in MoCA scores between Latinos with and without PD and whites with PD.
Background: Most studies examining cognition in PD have been conducted in white patients of European descent. The application of universal test cutoff scores across diverse linguistic, cultural, and ethno-racial populations contributes to misdiagnoses.
Method: We conducted a cross-sectional analysis of clinical, demographic, and environmental data from the Latin American Research Consortium on the Genetics of PD (LARGE-PD; 2,041 Latinos with PD and 1,303 Latino-controls) and the Parkinson’s Progression Markers Initiative (PPMI; 1,013 whites with PD) cohorts. We used multiple linear regression to examine factors associated with MoCA scores in the LARGE-PD cohort and differences in MoCA total and domain scores between the LARGE-PD and Latino-controls and PPMI cohorts. We also utilized repeated measures ANOVA and computed Reliable Change Indices to account for differences in disease duration and the number of assessments between the LARGE-PD and PPMI cohorts.
Results: After adjusting for age, sex, and years of education, the PPMI cohort had higher mean MoCA scores (25.9 ± 4.2) than the LARGE-PD (21.4 ± 5.9; p < .001) or Latino-controls (24.8 ± 3.81; p < .001) cohorts [figure 1]. Latinos with PD were more likely to have MoCA scores in the MCI (45.2% vs. 24.2%) or dementia (21.5% vs. 9.8%) range than whites with PD, even after applying recommended adjusted cutoffs (p < .001) [figure 2]. In the LARGE-PD cohort, unilateral symptom onset (p = .009) and higher educational attainment (p < .001) were associated with better MoCA scores, whereas older age (p < .001), higher Hoehn and Yahr scale scores (p < .001) the use of dopamine agonists (p = .01), and previous tobacco use (p = .01) were associated with lower MoCA scores.
Conclusion: The current cutoffs for impairment on the MoCA contribute to disproportionately higher rates of MCI and dementia in Latinos with and without PD. Clinicians and researchers should refrain from using MoCA cutoff scores established in white populations when working with Latinos with PD.
Figure 1. Group comparisons of MoCA scores
Figure 2. Distribution of MoCA and cutoff scores
To cite this abstract in AMA style:
S. Sperling, S. Anis, H. Mauricio Chaparro-Solano, T. Peixoto Leal, C. Sonneborn, C. Callegari Piccini, M. Inca-Martinez, M. Cornejo-Olivas, M. Illanes-Manrique, P. Chana-Cuevas, P. Safie Awad, A. Jimena Hernández-Medrano, A. Cervantes-Arriaga, A. Schuh, C. Rieder, P. Braga-Neto, A. Silva Sena, B. Lopes Santos-Lobato, E. Gatto, G. Alvarado, C. Avila, V. Tumas, M. Paula Foss, V. Borges, H. Ballalai Ferraz, J. Orozco Vélez, B. Muñoz Ospina, S. Moreno, D. Pineda, J. Rios Pinto, P. Olguín, J. Cristobal Nuñez, A. Viñuela, A. Espinal-Martinez, N. Mori, K. Mejía-Rojas, A. Medina-Colque, A. Zuma Rosso, C. Vilaça, E. Ochoa-Valle, I. Cornejo-Herrera, P. Reyes-Perez, A. Lázaro-Figueroa, A. Moraes Alves, R. Gisbert Cury, H. Fernandez, I. Mata. Comparative Analysis of MoCA Scores Between Latin American Latinos and White Patients with Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/comparative-analysis-of-moca-scores-between-latin-american-latinos-and-white-patients-with-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/comparative-analysis-of-moca-scores-between-latin-american-latinos-and-white-patients-with-parkinsons-disease/