![]() Tick the box under each word the subject produces on this first trial. Read the 5 words at a rate of one word per second. ![]() Give 1 point each for the following responses: – Hands: 2 hands jointly indicating correct time hour hand must be clearly shorter than minute hand hands must be centered within the clock face with their junction close to the clock center 2. Numbers: All numbers must be present with no additional numbers in correct order and placed in the approximate quadrants on the clock face Roman numerals acceptable numbers can be placed outside circle – Similar lengths (rectangular prisms are accepted) –Ĭontour: Clock face must be a circle with only minor distortion – Give 1 point for a correct drawing, 0 if any criteria not met: – No lines cross, and all errors are immediately self-corrected. The MoCA is a freely accessible cognitive screening tool that is available in multiple languages. Montreal Cognitive Assessment (MoCA) Scale Original English Version. See their website for more details.įigure 109.2. As of September 2020, completion of a 1-hour online training and certification regarding administration, scoring, and interpretation of the MoCA is required prior to clinicians using it in their clinical practice. The MoCA is free to clinicians ( ) and has been translated into 31 different languages and dialects. They found that 66% of their sample fell below the cut score of 26, indicating “impairment,” and that many of the MoCA items had high failure rates. Rossetti and colleagues (2011) attempted to correct these problems by conducting a normative study of the MoCA in an ethnically diverse sample of healthy participants, as presented in Table 44.5. Additionally, the original cut score of 26 used to identify impairment was developed without fully accounting for other variables that affect test performance (e.g., age, education, sex, and race) and the score has also been shown to identify a high number of false positives in certain populations. ![]() First, some studies have demonstrated that its reliability is notably low in nonclinical populations ( Bernstein et al., 2011), which indicates that it should primarily be used only to detect suspected cognitive impairment in clinical patients. Since its inception as a screening measure for MCI, other studies have found the MoCA to outperform the MMSE in screening for general cognitive impairment in Parkinson disease (PD) ( Hoops et al., 2009 Nazem et al., 2009), vascular dementia after acute stroke ( Dong et al., 2010), and Huntington disease (HD) ( Videnovic et al., 2010) as a measure sensitive to early stages of different types of dementia.Īlthough the MoCA has demonstrated its utility as a cognitive screener, there are a few caveats worth noting. More important, the positive predictive value of the MoCA is 89% for both MCI and AD. The total score ranges from 0 to 30 points, and a cut score of 26 has demonstrated very good specificity (by correctly identifying 87% of healthy participants) and excellent sensitivity when differentiating MCI (90%) and Alzheimer disease (AD) (100%) from healthy comparisons. Including more cognitive domains reduces the likelihood that impairments or disorders will be overlooked (e.g., executive dysfunction, a hallmark symptom of vascular dementia). The MoCA also improved upon the MMSE by probing more cognitive domains, including executive functioning, immediate and delayed memory, visuospatial abilities, attention, working memory, language, and orientation to time and place ( Fig. The MoCA was originally developed as a screening tool to correct the shortcomings of the widely used MMSE, which demonstrated an insensitivity to mild cognitive impairment ( Nasreddine et al., 2005). Joseph Jankovic MD, in Bradley and Daroff's Neurology in Clinical Practice, 2022 Montreal Cognitive Assessment
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