To detect Alzheimer's disease and other forms of dementia early on and monitor progression, there are several cognitive evaluations that can assist professionals in a diagnosis.

The Montreal Cognitive Assessment is an accurate test that can give examiners insight into a person's cognitive ability.

Test Description

The Montreal Cognitive Assessment (MoCA), developed in Canada in 1996, was intended to be a means of accurately detecting levels of cognitive impairment. The assessments in the test attempt to gauge areas of language, visuospatial abilities, memory and recall and abstract thinking, to give a representation of a person's current cognitive ability.

The MoCA is administered over approximately ten minutes, with 30 possible points. The test is made freely available to any clinician, and its international use allows it to be administered in 35 different languages.

Scoring

There are 11 sections of the assessment, with a total of 30 possible points:

  • (1 point) In “Alternating Trail Making," a patient is told to draw a line from letters to numbers, in ascending order (1-A-2-B-3-C-4-D-5-E), without crossing any lines. Any error will warrant a score of zero.
  • (1 point) The “Visuoconstructional Skills (Cube)" segment relays instructions to copy a drawing of a cube. If a three-dimensional drawing with relatively accurate lines is drawn, the point is awarded.
  • (3 points) In the “Visuoconstructional Skills (Clock)" portion, a patient is asked to draw a clock. One point each is awarded for having a contour, having numbers, and having hands.
  • (3 points) The “Naming" phase asks the patient to name each of three common animals, scoring one point for each correct answer.
  • (0 points) The first “Memory" section involves no points, and simply involves reading a list of five words to be recalled later.
  • (6 points) “Attention" requires a patient to successfully pay attention to verbal commands. Three smaller sections involve repeating digits, acknowledging spoken letters, and counting backward from 100 by sevens.
  • (2 points) “Sentence Repetition" involves two spoken sentences that are repeated: one point is scored for each successful repetition.
  • (1 point) “Verbal Fluency" tests a patient's vocabulary; if 11 or more specific words are spoken (such as words starting with a certain letter), the patient is scored one point.
  • (3 points) The “Abstraction" phase revolves around three pairs of words. A patient is awarded one point for each commonality he/she can identify.
  • (5 points) “Delayed Recall" forces the recall of the terms read in “Memory," approximately five minutes later.
  • (5 points) “Orientation" tests a patient's understanding of his current place and the current time.

Test Analysis

The total possible score is 30, with any score higher than 25 considered normal. Any score of 25 or less is considered to be an indication of some form of cognitive impairment, which can predict or identify the onset of dementia in patients.

The MoCA has been tested for reliability, and researchers have concluded that the test is a useful and accurate means of detecting mild dementia. However, it is necessary that the test be administered by a professional, and accompanied by a primary means of diagnosis.