The Montreal Cognitive Assessment (MoCA): a Common and Useful Tool

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What Is the Montreal Cognitive Assessment (MoCA)?

The MoCA is a quick, usually 10-15-minute screening test used to check basic cognitive functions like memory, attention, and problem-solving. It can help identify early signs of mild cognitive impairment (MCI) or other conditions that can affect how we think.

What the MoCa Measures

The MoCA helps detect subtle changes in thinking that may not show up in daily life. It measures several areas of cognition, including:

• Memory: recalling lists of words or short sentences

• Attention: focusing on simple tasks or repeating number sequences

• Language: naming objects

• Visuospatial skills: copying shapes or drawing a clock

• Executive function: problem-solving and flexible thinking

• Orientation: knowing the date and place

  
  

How the MoCA Is Administered

A healthcare provider will ask you to complete simple paper-and-pencil and/or verbal tasks. These may include those listed in the last section. The test is non-invasive and requires no preparation, so no worries there. 

What Do the MoCA Results Mean?

Scores range from 0 to 30. A score of 26 or higher is generally considered normal, while lower scores may suggest mild cognitive impairment or another issue affecting memory or thinking. However, results are only one part of the picture. Your healthcare provider will also consider other factors.

The MoCA itself is also designed to account for individual differences:

• Education: Add 1 point for those with 12 years of education or less.

• Language: Available in many languages.

• Culture: Word lists and examples can be adapted.

• Vision or hearing issues: Alternate written formats can be used.

• Motor limitations: Verbal responses can replace drawing or writing tasks.

  
  

When to Talk to Your Doctor About the MoCA

If you or someone you know notices changes in memory, attention, or decision-making, talk to your primary care doctor. They can determine whether the Montreal Cognitive Assessment (MoCA) or another evaluation is appropriate.

The MoCA is often recommended for:

• Older adults during routine checkups

• People noticing new or worsening memory or thinking issues

• Those with risk factors like diabetes, high blood pressure, or a past stroke

• Patients being evaluated for neurological or psychiatric conditions

In general, there may be no fixed schedule for repeating the test. It may be done when symptoms appear, annually to track changes, or after treatments or lifestyle adjustments that could affect cognition.

What You Can Do to Support Brain Health

If your MoCA results suggest possible cognitive changes, keep in mind that there are many ways to stay proactive.

• Follow up with your healthcare provider for further evaluation or referral to a specialist.

• Review medications and health conditions that might affect thinking or memory.

• Engage in cognitive or memory support programs if recommended.

You can also strengthen overall brain health through daily habits:

• Get enough sleep and try to manage stress.

• Exercise regularly and eat a heart-healthy diet.

• Stay mentally active with reading, puzzles, or learning new skills.

• Stay socially connected.

• Keep blood pressure, blood sugar, and cholesterol under control.

  
  

References 

Andrew Rosenzweig, MD. “Montreal Cognitive Assessment (MOCA) Test for Dementia.” Verywell Health, www.verywellhealth.com/alzheimers-and-montreal-cognitive-assessment-moca-98617. 

Fitzgerald, Nancy. What Is Cognitive Testing — and Should You Ask for It? - Silversneakers, www.silversneakers.com/blog/what-is-cognitive-testing/. 

“Mild Cognitive Impairment (MCI).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Oct. 2024, www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/diagnosis-treatment/drc-20354583.

“MOCA Test.” MoCA Cognition, mocacognition.com/the-moca-test/. 

Montreal Cognitive Assessment (MOCA) - Physiopedia, www.physio-pedia.com/Montreal_Cognitive_Assessment_(MoCA). 

Montreal Cognitive Assessment - an Overview | Sciencedirect Topics, www.sciencedirect.com/topics/medicine-and-dentistry/montreal-cognitive-assessment. 

Pedersen, Traci. “MOCA Test for Dementia: Usage, Scoring, Accuracy.” Healthline, Healthline Media, 18 Aug. 2023, www.healthline.com/health/dementia/moca-test-for-dementia. 

Wood, Jessica L et al. “Montreal Cognitive Assessment (MoCA) Performance and Domain-Specific Index Scores in Amnestic Versus Aphasic Dementia.” Journal of the International Neuropsychological Society: JINS vol. 26,9 (2020): 927-931. doi:10.1017/S135561772000048X

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