The Montreal Cognitive Assessment (MoCA) helps assess people with dementia. This is a 30-question test that takes about 10 to 12 minutes to complete. The test was published in 2005 by a group at McGill University who worked for several years at a memory clinic in Montreal.
Here’s what the MoCA includes, how it’s scored and interpreted, and how it can help identify dementia.
MoCA examines different types of cognitive or thinking abilities. These include:
- Directions: The exam administrator asks you to state the day, month, year, date, location, and city.
- Short-term memory/delayed recall: Read five words. Ask the test taker to repeat them. After completing the other tasks, ask the person to repeat each of the five words again. If they don’t remember them, they get a hint of the category the word belongs to.
- Executive Function/Visuospatial Abilities: These two abilities were tested by the Trails B Test. It requires you to draw a line to arrange alternating numbers and letters (1-A, 2-B, etc.). The test also requires you to draw a cube shape.
- Language: This task requires you to repeat two sentences correctly. Then it will ask you to list all the words in the sentence that start with the letter “F”.
- Abstraction: You are asked to explain how two items are similar, such as a train and a bicycle. This checks your abstract reasoning, which is often impaired in dementia. The proverb interpretation test is another way to measure these skills.
- Animal naming: Three pictures of animals are shown. The person was asked to name everyone. This is mainly used to test the fluency of the language.
- NOTE: Candidates are asked to repeat a series of numbers forward and then a different number backwards. This task tests the ability to pay attention.
- Clock Drawing Test: Unlike the Mini Mental State Exam (MMSE), the MoCA requires you to draw a clock that reads eleven and eleven.
Importantly, the test is performed in the patient’s native language to ensure accuracy.
MoCA scores range from zero to 30. A score of 26 or higher is considered normal.
In the original study data, the average score for the normal control group was 27.4. Those with mild cognitive impairment (MCI) scored an average of 22.1. Alzheimer’s patients had an average score of 16.2.
The score breakdown is as follows:
- Visual Spatial and Executive Function: 5 points
- Animal naming: 3 points
- Note: 6 points
- Language: 3 points
- Abstract: 2 points
- Delayed recall (short-term memory): 5 points
- Orientation: 6 points
- Educational Attainment: Add 1 point for candidates with 12 years or less of formal education
MoCA helps health professionals quickly determine if someone’s thinking skills are impaired. It can also help them decide whether an in-depth diagnostic test for Alzheimer’s disease is needed.
It may help predict dementia in patients with mild cognitive impairment (MCI). Because it tests executive function, it is more sensitive than MMSE in this regard. Finally, it has been shown to better identify cognitive problems in people with Parkinson’s disease.
Advantages and disadvantages
MoCA is short, simple, and reliable as a screening test for Alzheimer’s disease. It examines executive function, an important component of dementia that cannot be measured by the MMSE. Unlike MMSE, it is free for non-profit use.
MoCA is available in over 35 languages. Versions to test for people with hearing loss and visual impairment have also been developed.
One disadvantage of MoCA is that the administration time is slightly longer than MMSE. It should also be used along with various other screenings and tests to diagnose dementia.
Early diagnosis of mental decline is important. The MoCA is a 30-item test that gives healthcare providers an idea of how a person’s thinking skills work.
This test examines language, memory, visual and spatial thinking, reasoning and orientation skills. Using it, healthcare providers can quickly determine when someone may need more comprehensive testing for Alzheimer’s or dementia.
Understanding what MoCA includes and how it’s scored can help you better understand its results for you or a loved one. MoCA should be provided by a physician in conjunction with several other assessments. This allows the best and most accurate assessment of mental function to identify possible causes of memory loss.
Frequently Asked Questions
Will MoCA test your short-term memory?
Yes, this is called the short-term memory/delayed recall portion of MoCA. The test taker will read five words and repeat them out loud. After completing some of the other MoCA tasks, ask the person to repeat the previous five words. If they don’t remember the words, they are prompted for their category.
Are there different types of cognitive function tests?
Yes, there are different kinds of cognitive function tests. In addition to the MoCA, other common tests include the Mini Mental Status Examination (MMSE) and the Mini Gear. These efforts are similar to MoCA, but with a slightly different purpose; MoCA is generally applicable to mild cognitive impairment, whereas more severe cognitive problems may be easier to detect using MMSE.
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