The Montreal Cognitive Assessment (MoCA) for Mild Cognitive Impairment and Alzheimer's Disease

The home of the Montreal Cognitive Assessment tool is www.mocatest.org.

Here is a YouTube video, Montreal Cognitive Assessment (MoCA) Administration, that was given to a patient after he failed the MiniCog on an earlier visit [Link to MiniCog PDF – See the YouTube videos on administration of MiniCog in Additional Resources below] .

Here is the YouTube video, Montreal Cognitive Assessment (MoCA): Administration and Scoring

The best place to start learning about the test is the About page [below are some excerpts from that page]:

In 2003, after analysis of the 2000 study results, a few elements of the test were optmized, and a new validation study was completed in 2003-2004, which confirmed the test’s discriminatory ability to distinguish Normal controls, from subjects with Mild Cognitive Impairment or Mild Alzheimer’s disease (Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JLC, Chertkow H. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. J Am Geriatr Soc 53:695–699, 2005).

The Memory Index Score (MoCA-MIS), consists of scoring the memory cueing section which was only assessed qualitatively. This score was created in 2010 and validated in a study in 2013 (Julayanont P, et al. JAGS 2014). The MIS score helps determine which patient with Mild Cognitive Impairment is most likely to convert to Dementia over an average follow-up of 18 months. This score will help clinicians monitor more closely high risk patients, and researchers select subjects that are more likely to benefit from therapeutic interventions. Following the addition of the Memory Index Score to the MoCA test, a new version of
the test, Version 8.1, was created, which replaces version 7.1.

Several neurological and systemic diseases are accompanied by cognitive impairment. The MoCA has been found to be useful to detect mild cognitive impairment in many conditions including Alzheimer’s disease, Vascular Cognitive Impairment, Parkinson’s disease, Lewy Body, Fronto-temporal dementia, Multiple Sclerosis, Huntington disease, Brain Tumors, ALS, Sleep Apnea, Heart Failure, Substance abuse, Schizophrenia, HIV, and Head Trauma.

The site is full of useful information on the use of the test including a good FAQ page that includes tips on administration, scoring, and interpretation.

Clinical use of the test (Permissions) is free for the following:

Universities/Foundations/Health Professionals/Hospitals/Clinics/Public Health Institutes:

MoCA© may be used, reproduced, and distributed WITHOUT permission.
The test should be made available free of charge to patients.
Written permission and Licensing Agreement is required if funded by commercial entity or pharma.
To request permission, please fill out the form below [Click on Permissions].

The MoCA application for electronic tablets will improve the reliability of testing and retesting. Instructions for administering and scoring the test will be posted for the administrator before and after each cognitive subtest respectively [Not currently available at the time of this post].

The electronic version increases measurement precision and improves clinical or therapeutic trial monitoring [Not currently available].

Many neurological and systemic conditions are [Again not currently available at the time of this post] associated with slowed processing speed that begins before the loss of cognitive function. The total MoCA score may not always capture slowed processing speed. Execution time is measured by the second by the electronic test for each MoCA subtest which will most likely enable clinicians to detect cognitive impairment much earlier than before.

[Training and Certification in MoCA will be available but is not currently at the time of this post (12-3-2015)]

The MoCA is recommended by the Canadian Consensus Conference for Diagnosis and Treatment of Dementia Guidelines for Alzheimer’s disease since 2007, and the NIH and Canadian Stroke Consortium for Vascular Cognitive Impairment since 2006.

The MoCA validation study (Nasreddine et al. JAGS 2005) is identified by Thomson Reuters’ Essential Science Indicators as one of the most cited papers in the research area of “mild cognitive Impairment” in 2009.

The MoCA is used in 100 countries around the world (MoCA wesbite Stats 2013)

MoCA is among top innovations in Alzheimer’s Research in Canada, according to Canadian Institute of Health Research (2013).