MoCA and Clock Test Correction

MoCA Scales and Adjustment for Schooling

The maximum MoCA score is 30 points. A distinctive feature of its correction is the adjustment for educational level: if the patient has less than 12 years of formal schooling, 1 point should be added to the final score to compensate for educational bias. As for interpretation, a score of 26 or more is considered normal.

Lower scores suggest mild cognitive impairment or dementia, depending on the severity of the drop in performance, using scales similar to the MMSE for severity ranges.

Clock Test Scoring Criteria

The Clock Test can be applied within the MoCA or as a stand-alone test to assess visuospatial and executive functions, especially in suspected Alzheimer's disease.

The instruction is to draw a clock with hands marking a specific time (e.g., 11:10).

Three fundamental criteria are evaluated, awarding up to 3 points for each (total 9 points): the outline (complete and closed dial), the numbers (presence, correct sequence and order) and the hands (presence, central junction and correct time).

A score of 9 indicates normal function; 6 points suggests possible impairment; and 3 points or less indicates severe cognitive impairment.

Summary

The maximum MoCA score is thirty, with a score equal to or greater than twenty-six being considered normal. It is mandatory to add an additional point to the final score if the patient has low formal schooling.

The Clock Test evaluates visuospatial and executive functions, asking to draw a dial with numbers and hands marking the time. It can be applied independently or as part of larger batteries such as the MoCA.

Three criteria are scored: outline, numbers and needles, totaling a maximum of nine points. A score of six suggests possible impairment, and three or less indicates severe cognitive compromise in the patient.