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The Montreal Cognitive Assessment (MoCA) was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. The MoCA may be administered by anyone who understands and follows the instructions, however, only a health professional with expertise in the cognitive field may interpret the results. Time to administer the MoCA is approximately 10 minutes. The total possible score is 30 points; a score of 26 or above is considered normal. All instructions may be repeated once. 1. Alternating Trail Making: Administration: The examiner instructs the subject: "Please draw a line going from a number to a letter in ascending order. Begin here [point to (1)] and draw a line from 1 then to A then to 2 and so on. End here [point to (E)]." Scoring: One point is allocated if the subject successfully draws the following pattern: 1- A- 2- B- 3- C- 4- D- 5- E, without drawing any lines that cross. Any error that is not immediately self-corrected (meaning corrected before moving on to the Cube task) earns a score of 0. A point is not allocated if the subject draws a line to connect the end (E) to the beginning (1).
Administration: The examiner gives the following instructions, pointing to the cube: “Copy this drawing as accurately as you can.” Scoring: One point is allocated for a correctly executed drawing. • Drawing must be three-dimensional. • All lines are drawn. • All lines meet with little or no space. • No line is added. • Lines are relatively parallel and their length is similar (rectangular prisms are accepted). • The cube’s orientation in space must be preserved. A point is not assigned if any of the above criteria is not met. 3. Visuoconstructional Skills (Clock): Administration: The examiner must ensure that the subject does not look at his/her watch while performing the task and that no clocks are in sight. The examiner indicates the appropriate space and gives the following instructions: “Draw a clock. Put in all the numbers and set the time to 10 past 11.” Scoring: One point is allocated for each of the following three criteria: