During the Montreal Cognitive Assessment (MoCA), a person completes short tasks involving memory, attention, language, reasoning, drawing, calculation, and orientation. An examiner scores the roughly 10-minute assessment out of 30, but the result alone cannot diagnose dementia. The MoCA is a screening tool designed to identify possible cognitive impairment. The Alzheimer's Association's MoCA administration instructions describe the abilities it samples and how each response is scored.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Drawing, naming, and learning tasks
- Attention, language, and reasoning tasks
- Delayed recall and orientation
- What the final score means
Drawing, naming, and learning tasks
The test begins with visuospatial and executive tasks. The person alternates between numbers and letters in sequence, copies a three-dimensional drawing, and draws a clock showing 10:05. The clock receives separate points for its outline, numbers, and hands.
These tasks examine how the person organizes information, follows a sequence, and represents spatial relationships. Next, the person names pictured animals and listens to a five-word list twice. The two learning trials do not earn points; they introduce words the examiner will ask about later. These procedures appear in the Alzheimer's Association's detailed MoCA instructions.
Attention, language, and reasoning tasks
For attention, the examiner asks the person to repeat digits forward and backward. The person also taps when hearing a target letter and repeatedly subtracts seven from 60 without using fingers, paper, or a pencil. Language tasks include repeating two sentences exactly and naming words that begin with a specified letter.
Producing at least 11 qualifying words within one minute earns one point. The abstraction portion presents two pairs of words. The person explains the broader category or quality shared by each pair, rather than describing a superficial similarity.
Delayed recall and orientation
Later in the test, the examiner asks the person to recall the five words introduced earlier. Only words remembered without help count toward the standard delayed-recall score. For missed words, the examiner may offer a category clue and then multiple-choice options.
According to the Alzheimer's Association's MoCA scoring instructions, responses to these cues can contribute to a separate memory Index Score, but not to the standard uncued-recall points. The orientation questions cover the date, day, month, year, current place, and city. After totaling all sections, the examiner adds one point for someone with 12 or fewer years of formal education, without allowing the total to exceed 30.
What the final score means
Standard MoCA material describes a score of 26 or higher as normal. A lower score is a screening signal that needs clinical interpretation, not proof that someone has dementia.
A full dementia evaluation considers the cognitive result alongside medical history and neurological and functional assessments. Imaging, laboratory testing, or biomarker testing may also form part of the evaluation because no single test determines Alzheimer's disease or another dementia, according to the Alzheimer's Association's diagnostic guidance. When discussing the result, ask how the score fits the person's history and everyday functioning, whether the education adjustment was applied, and what further evaluation—if any—should happen next.
