The Montreal Cognitive Assessment (MoCA) was designed by Dr. Ziad Nasreddine in Montreal, Canada in the year 1996. This assessment method was authenticated and legalized to diagnose slight cognitive impairment in people. Since then, the (MoCA) has been widely regarded and practiced around the world as a very effective method to assess mild cognitive impairment.
The MoCA consists of a 30-point test which is usually spread around 10 minutes. If you are a clinician you can get access to the instructions associated with the MoCA on the internet.
Though the original test is in English, it can be adjusted for people who speak other accents.
What Happens in a MoCA?
The Montreal Cognitive Assessment diagnoses a number of different areas associated with cognitive impairment. It assesses the person’s quick memory function which involves the patient learning five nouns in separate intervals and then the patient is asked to recall what he has learned (5 points for this).
It assesses a patient’s Visuospatial abilities and involves clock drawing and a cube which is in 3D, (3 points for drawing a clock correctly and 1 point for drawing the cube).
The MoCA also analyses a patient’s executive function which directly relates to our working memory. If someone has trouble connecting his experiences from the past to the present and has trouble making decisions, planning, paying attention, managing time and/or organizing his life then he is suffering from a loss in executive function which is a part of cognitive impairment.
The MoCA provides (TMT-B) tasks, Trail Making Tasks-B, (worth 1 point), Verbal fluency tasks (1 point) and a Verbal communication intelligence task with two items (2 points). The patient’s motor skills, working memory, concentration and his attention to instructions given are also evaluated by using different attention tasks.
These include detecting things using tapping (1 point), subtracting for example being asked to subtract 7 from 40 (3 points) and being asked to place digits either forwards or backwards (1 point for each).
Through the Montreal cognitive assessment a patient’s language fluency is also evaluated. Various tests like three item confrontation in which you have to name three unfamiliar animals for example a rhinoceros, camel and a bison (3 points).
Another test which engages the person in to speaking complexly arranged sentences is also undertaken (2 points are given for this). Lastly the patient’s ability to successfully determine the time and date he is in is assessed (this is 6 for points).
Montreal Cognitive Assessment Scores
The MoCA results are given on the points scored between 0 and 30. People who score higher than 26 or 26 are generally considered to be functioning normally.
Research done be clinicians using the Montreal cognitive assessment have concluded that people who succeeded in the assessment usually scored over 27 in comparison to those who score 22.1 (which means they are suffering from a milder form of cognitive imbalance). Those who scored 16.2 had Alzheimer’s.
Is the MoCA Convenient?
The Montreal cognitive assessment is a relatively convenient procedure which allows medical professionals to accurately and quickly determine whether or not someone is suffering from a considerable imbalance of cognitive function.
The MoCA determines whether or not a person requires extensive treatment in case of Alzheimer’s disease. The MoCA also determines certain symptoms and allows doctors to keep such a situation from worsening.
Doctors using the MoCA are allowed to evaluate whether or not a person has dementia as a result of mild cognitive impairment. And the sole reason they can do this is because the MoCA involves evaluating a person’s executive function (as explained above).
Overview of the Pros and Cons of MoCA
Some of the major advantages of the Montreal cognitive assessment include simplicity, easy for the patient, reliable outcome and the screening process involved to determine whether or not a person has Alzheimer’s disease. Furthermore, the MoCA also measures the various hints of dementia present in a person.
The Mini-Mental State Exam (MMSE) does not measure the components of dementia. The MoCA also works well to determine symptoms for Parkinson’s disease. Unlike the MMSE test the MoCA has been declared free to use, involving no payments.
The only potential drawback of the Montreal cognitive assessment is that the desired outcome can only be accurately achieved in memory clinic settings. According to Assistant clinical professor at UCSD and the author of a study on the application of MoCA in comparison to MMSE, Dr.
Stephanie Lessig the MoCA is newer to the scene and originally just looked at patients with milder forms of Alzheimer’s. The MoCA has since gone on to being used for other diseases as well. It seems to be a little better at looking in depth at some of the deficits that the MMSE might not pick up.
For instance, the MMSE has a heavy language component, but that’s not an area that tends to be as much a deficit [in the early stages] of conditions like Parkinson’s or other forms of dementia, so that’s where the MoCA comes in at being a little more sensitive.
According to a study made by Stephanie Lessig it was found that the MoCA successfully manages to point out subtle insufficiencies in cognitive behavior with the patients suffering from Parkinson’s disease. This is not the case with the MMSE though many prefer to use the MMSE.
The MoCA is regarded as a very useful tool in recognizing certain abnormalities in cognitive behavior under normal circumstances but it has been proven not to work that effectively against patients who have severe dementia or cognitive impairment.
The idea of getting examined through the Montreal cognitive assessment or any other assessment for that matter is often very disheartening and discouraging to slightly older people. They chances of them getting panicky and confused before an assessments are high.
The anxiety may lead to poor performance on the MoCA. So it is important to take this test confidently in order to get accurate results. Not taking the test has no upside.