Montreal Cognitive Assessment (MoCA)

Sensitivity and Differences with the MMSE

The MoCA Test, of Canadian origin (1996), was created to assess mild cognitive dysfunctions, being more sensitive than the MMSE to detect early stages of deterioration.

Its application lasts between 10 and 15 minutes and is recommended from 8 years of age.

Unlike the MMSE, the MoCA includes more complex executive function and abstraction tasks, making it a more robust tool for cognitive profiles that might be missed in a more basic screening.

Domains Assessed and Specific Tasks

MoCA assesses eight cognitive domains. The Visuospatial/Executive domain (5 items) includes a sequence of numbers and letters (Trail making B), copying a cube, and drawing a clock.

Identification (3 points) requires naming three animals (lion, rhinoceros, dromedary/camel).

Memory is not scored in the immediate phase, but involves learning 5 words (face, silk, church, carnation, red).

Attention (6 points) includes direct and inverse number series, and clapping before the letter 'A'.

Language (3 points) assesses repetition of complex sentences and verbal fluency (words with 'P' or 'S' depending on the version).

Abstraction (2 points) looks for similarities (e.g. train-bicycle). Finally, Deferred Recall (5 items) and Orientation (6 items) are evaluated.

Summary

The MoCA Test (1996) detects mild cognitive dysfunctions, surpassing the MMSE in sensitivity. It evaluates complex executive functions and abstraction, and is administered in about ten minutes to people from eight years of age.

It examines multiple domains such as visuospatial, by means of clock and cube drawing, animal identification and delayed memory, using a five-word learning list for its evaluation.

It also assesses attention with numerical series, language through verbal fluency and repetition, and abstraction ability. It is a robust tool for profiles that would be missed in more basic screening.