Montreal Cognitive Assessment

Montreal Cognitive Assessment (MoCA, also Nasreddin's test) was developed in 1996 by a Canadian specialist in cognitive disorders and Alzheimer's disease, Dr. Ziad Nasreddine, and subsequently published in 2005 (Nasreddineet al., 2005). It was introduced to the Czech environment in 2006 by J. Reban. Currently, there is already a seventh version of the original test, which can be freely obtained in 55 different languages. This test, together with others such as the MMSE ("Minimental State Examination"), the Addenbrooke's cognitive test or the "7-minute" test, is among the cognitive screening tests used to diagnose dementia. Currently, the MoCA test is still used more as a supplement to the MMSE test.

Usage
MoCA has a relatively wide range of uses, as it evaluates multiple cognitive domains, and thus can be useful in the detection of various neurological diseases. It is mainly used to detect the early stages of Alzheimer's dementia and mild cognitive impairment, but also Parkinson's disease, Huntington's disease, vascular cognitive disorders, brain metastasis, primary brain tumors, multiple sclerosis, depression, schizophrenia, etc.

Structure
The test takes approximately ten minutes to complete and is worth a maximum of 30 points. The following cognitive abilities are assessed: dexterity (connecting numbers), spatial orientation (drawing a cube), visual construction skills (drawing a clock and marking a certain time), naming an animal, memory, attention, repeating sentences, recalling words, abstraction, later acquisition of words, orientation.

Results
People with Alzheimer's have the lowest scores on most abilities. In persons with mild cognitive impairment, attention is not impaired, but scores on other items are also low. We observe the highest scores in cognitively healthy individuals. With a MoCA score < 26 points, the sensitivity for determining dementia is 90% and the specificity is 87%. Compared to the primary screening cognitive test MMSE, the MoCA additionally evaluates frontal functions, and a more detailed evaluation is found in memory and visual-spatial functions. Czech MoCA standards for older adults were also published with a conversion between the MoCA test and the MMSE. Data are also available regarding the index of reliable change applicable to repeated use of the test.

Related articles

 * Mini Mental State Exam
 * Dementia
 * Alzheimer's disease