MONTREAL COGNITIVE ASSESSMENT MOCA instructions

The Trail Making Test in prodromal Huntington disease: contributions of disease progression to test performance. O’Rourke JJF, Beglinger LJ, Smith MM, Mills J, Moser DJ, Rowe KC, et al. The differential contribution of mental tracking, cognitive flexibility, visual search, and motor speed to performance on parts A and B of the Trail Making Test. Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. Sánchez-Cubillo I, Periáñez JA, Adrover-Roig D, Rodríguez-Sánchez JM, Ríos-Lago M, Tirapu J, et al. The trail making test, part B: cognitive flexibility or ability to maintain set? Appl Neuropsychol. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The MoCA is freely accessible for clinical and educational purposes ( and is available in 36 languages and dialects. Norms in lesser educated, community based, multi-cultural samples will hopefully be available to help first line healthcare providers better assess subjects presenting with cognitive complaints. MoCA was developed in a memory clinic setting and normed in a highly educated population. Executive functions, higher-level language abilities, and complex visuospatial processing can also be mildly impaired in MCI participants of various etiologies and are assessed by the MoCA with more numerous and demanding tasks than the MMSE. The MoCA’s memory testing involves more words, fewer learning trials, and a longer delay before recall than the MMSE. There are several features in MoCA’s design that likely explain its superior sensitivity for detecting MCI. MoCA is also sensitive to detect cognitive impairment in cerebrovascular disease and Parkinson’s disease, Huntington’s disease, brain tumors, systemic lupus erythematosus, substance use disorders, idiopathic rapid eye movement sleep behaviour disorder, obstructive sleep apnoea, risk of falling, rehabilitation outcome, and epilepsy. MoCA’s sensitivity and specificity to detect subjects with MCI due to Alzheimer’s disease and distinguish them from healthy controls are excellent.

Its validity has been established to detect mild cognitive impairment in patients with Alzheimer’s disease and other pathologies in cognitively impaired subjects who scored in the normal range on the MMSE.

It is a simple 10 minute paper and pencil test that assesses multiple cognitive domains including memory, language, executive functions, visuospatial skills, calculation, abstraction, attention, concentration, and orientation. The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument developed to detect mild cognitive impairment (MCI).

MONTREAL COGNITIVE ASSESSMENT MOCA instructions