To help detect early signs of dementia, the MoCA assesses various cognitive functions like memory, attention, language, and more.

Screening tests for dementia offer a way to identify impairments in a person’s ability to think as well as other early indicators of the condition, particularly in individuals who might not yet display noticeable symptoms.

One widely recognized screening tool is the Montreal Cognitive Assessment (MoCA), designed to detect the condition at an early stage. This allows for timely intervention and management.

The MoCA is often used as an initial screening tool to detect the presence of cognitive impairment, such as dementia.

The test assesses various mental processes, such as memory, attention, language, and executive skills. This can give healthcare professionals an overall picture of your cognitive abilities.

If you or a loved one scores below a certain threshold on the MoCA, it may indicate the need for further assessment or more comprehensive testing to confirm the extent and nature of cognitive concerns.

The MoCA takes about 10 minutes to complete and is available in many languages.

The MoCA assesses cognitive performance across several domains, which can vary depending on how they’re categorized.

Some sources might group these into six broader domains. Others might provide more detailed breakdowns, resulting in a count of nine or more specific areas of assessment.

The core domains include:

The MoCA test is scored by assigning points to different sections and tasks within the test.

The scores from each section are added up to get the total MoCA score, which ranges from 0 to 30. A higher score indicates less impaired cognitive function.

The specific cutoff score for determining dementia can vary, but a score of 26 or below is often used as a potential sign (indicator) of impairment.

What MoCA score indicates dementia?

A MoCA score of 26 or below is often considered an indicator of cognitive impairment, which could include conditions like mild cognitive impairment or dementia. Yet the exact interpretation of the score may vary based on factors such as age, education level, and the specific clinical context.

The accuracy of the MoCA test may vary depending on the specific context and population being assessed.

It appears to be particularly effective at identifying cognitive changes in individuals with higher education levels or when mild cognitive changes are the main focus of clinical attention.

But its accuracy can be influenced by factors such as the characteristics of the person being tested and the setting in which the test is administered.

One study from 2020 assessed the MoCA’s effectiveness in detecting cognitive concerns among older adults in an outpatient mental health clinic. The test was able to confirm a typical ability to think and rule out severe issues like dementia. Yet researchers note that its reliability for diagnosing these problems was limited.

In addition, when these results were compared to the performance of healthy individuals, the MoCA appeared to be more effective than it is in real clinical settings. This implies that while the MoCA can identify people needing more tests, it’s not ideal for diagnosing cognitive issues conclusively.

A 2017 study looked at how well the MoCA works for people with Parkinson’s disease. The researchers found that some parts of the MoCA, like the executive function section that deals with planning and organization, were good at spotting concerns. But other parts, like paying attention and using language, didn’t work as well.

A 2021 review of seven studies found that, when practitioners used a score of less than 26 as a cutoff, the MoCA correctly detected more than 94% of people with dementia in different situations.

Yet, using this cutoff also led to a significant number of incorrect results, with over 40% of people without dementia being mistakenly identified as having dementia.

The authors say that the quality of the studies conducted on this topic wasn’t high enough to strongly recommend using the MoCA test for dementia diagnosis in various healthcare settings. Further research is needed, especially to determine the best score threshold for accurate dementia diagnosis, especially in primary care settings.

The MoCA test is generally recommended for individuals who are suspected of having cognitive impairment or dementia.

The test is particularly useful for those with higher education levels or when mild cognitive changes are a concern.

One study from 2022 found that the MoCA’s results can be influenced by how much education someone has. The test was more likely to indicate that people with less education had cognitive concerns even if they did not.

For this reason, the researchers altered the test to make it fairer for everyone. This new version still needs to be tested in more studies, but it might be better for people with less education.

Who administers the MoCA test?

Healthcare professionals — such as doctors, nurses, psychologists, or trained medical staff — typically administer the MoCA test.

In the realm of cognitive assessment, the Montreal Cognitive Assessment (MoCA) is considered a valuable tool for detecting early signs of cognitive impairment and conditions like mild dementia.

While its sensitivity and specificity make it effective at screening, it’s essential to understand its limitations. Overall, the MoCA can be a powerful aid in flagging potential cognitive concerns, helping to identify those in need of further evaluation.