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Testing for Dementia: The Montreal Cognitive Assessment (MoCA)

If you suspect that your older adult could be showing signs of cognitive impairment and not just having moments of normal forgetfulness, the first step is to visit their primary doctor for a full check-up.

If there aren’t any obvious causes of dementia-like symptoms, the doctor might use a test called the Mini Mental Status Exam (MMSE) to screen for possible cognitive issues.

However, there’s a more sensitive, but less common, screening test called the Montreal Cognitive Assessment (MoCA).


How the Montreal Cognitive Assessment (MoCA) works

The Montreal Cognitive Assessment (MoCA) is a one page, 30 point test that takes about 10 minutes and doesn’t require the doctor to have any special training.

The MoCA usually tests these cognitive areas:

  • Ability to process and understand visual information about where objects are

  • Executive functions – ability to manage cognitive processes

  • Language

  • Short-term memory recall

  • Attention

  • Concentration

  • Working memory

  • Awareness of time and place


How are the MoCA and MMSE different?

The MoCA looks similar to the MMSE, but the MoCA tests a variety of different cognitive functions and the MMSE focuses mostly on memory and recall.

The MoCA is generally better at detecting mild impairment and early Alzheimer’s disease because it’s a more sensitive test and is more challenging.

So, if a doctor sees a patient who is questioning their mental functioning, they might give the MoCA.

But if a patient comes in and is clearly cognitively impaired, a very sensitive test wouldn’t be as necessary since the issues are more obvious.


The MoCA has also been shown to be a better screening tool for conditions like:

  • Parkinson’s disease

  • Vascular dementia

  • Traumatic brain injury (often from falls)

  • Huntington’s disease

  • Brain tumors

  • Multiple sclerosis


How are the MoCA and MMSE similar?

Even though these are good screening tools for cognitive impairments, neither test was designed to diagnose cognitive conditions.

They’re both initial screening tests that are used to determine whether further cognitive testing is needed.

They also can’t be used to distinguish between conditions.

For example, you couldn’t use either test to diagnose someone with Alzheimer’s disease versus frontotemporal dementia. After the initial screening, more testing would be needed.


This article was featured at Daily Caring:
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