The Montreal Cognitive Assessment (MoCA) test can detect mild cognitive impairment or early signs of dementia. Healthcare professionals can interpret the level of impairment based on a score out of 30.

Dementia is a loss of cognitive functioning, which means that a person loses the ability to think, reason, and remember. The condition, which physically affects the brain, may take years to develop.

As dementia is progressive, a person may find that their cognitive ability deteriorates as time passes. About one-third of people aged 85 years or older may have a form of dementia. However, the condition is not a normal part of aging.

Before the MoCA test became available, healthcare professionals used the Mini-Mental State Examination (MMSE) to detect dementia. However, the MMSE is significantly less sensitive in detecting mild cognitive impairment.

The MoCA test can detect dementia but not differentiate between dementia types.

This article looks at the MoCA test for dementia in more detail, including how it works, what to expect, what the results mean, and more.

A woman doing an MoCA test for dementia.Share on Pinterest
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The MoCA test is a method of detecting mild cognitive impairment or early signs of dementia. The test is available in multiple languages.

The MoCA test examines various cognitive functions, including:

  • short-term memory
  • working memory
  • attention
  • executive functioning
  • visuospatial capacity, which is the ability to identify relationships between objects
  • the ability to understand and use language
  • a person’s relation to time and place

Healthcare professionals use the MoCA test to determine whether a person requires further tests or interventions for dementia.

According to a 2019 study, the MoCA assessment test works well for people in clinical and psychiatric settings.

Research is ongoing as to the effectiveness of the test in other settings. The test may detect early dementia as well as mild cognitive impairment.

Alongside the test, a healthcare professional may examine a person’s medical history and order laboratory tests to further investigate their health.

According to a 2015 journal article, professionals use the MoCA test for people:

The MoCA test, which consists of a 30-point assessment on one side of an A4 page, takes about 10 minutes to complete.

A person can do the test on paper or online via an app. There are also versions of the test for those who are blind or hard of hearing. It is also possible to adjust the scores for people with lower levels of education.

The test contains different sections that examine different aspects of cognitive function. It may include:

  • A memory questionnaire: This section assesses a person’s ability to recall personal and nonpersonal memories.
  • A visual association test (VAT): During the VAT, a person will identify objects in an illustration — for example, a monkey holding an umbrella — and explain how they interact. They may later have to recall what objects were present in the illustration.
  • A drawing test: A professional may ask a person to replicate a drawing, such as a clock face that shows a specific time.
  • Calculation and literacy tests: A person may have to work out simple sums. They may also have to do spelling and reading tests.

A person can gain a maximum of 30 points from the test, and professionals consider a score of 26 or above to be normal.

A score of 25 points or less may indicate some degree of cognitive impairment.

According to the frequently asked questions section of the MoCA website, the following result ranges may indicate cognitive impairment:

  • 18–25 points: Mild cognitive impairment.
  • 10–17 points: Moderate cognitive impairment.
  • Fewer than 10 points: Severe cognitive impairment.

However, a person’s level of educational attainment may affect their score.

Researchers update the test regularly.

This table shows the differences between the older MMSE test and the MoCA test.

Mini-Mental State ExaminationMontreal Cognitive Assessment Test
Researchers introduced it in 1975.Researchers introduced it in 2005.
It consists of 30 questions, which people answer using a pen and paper.It consists of 30 questions. People can do the test on paper or online through an app.
Researchers did not design it to identify the early stages of dementia. Researchers designed it specifically to identify mild cognitive impairment.
The test is copyrighted, so each test set requires an official form from the copyright owners. Medical professionals who administer the test must undergo free training before carrying out an assessment.
The test has multiple language translations. The test has multiple language translations and versions for people with impaired vision or hearing and those who have a low educational attainment.
A score of fewer than 24 points indicates mild cognitive impairment. A score below 26 points indicates mild cognitive impairment.
The test evaluates attention span, memory orientation, registration, recall, calculation, language, and the ability to draw a complex polygon. The test evaluates attention span, concentration, orientation, visual and spatial awareness, short-term memory, working memory, language, and the ability to draw a clock face showing a stated time.
Professionals do not think it is sensitive enough as a stand-alone test to assess early signs of dementia. The test is highly sensitive and can detect mild cognitive impairment and early signs of dementia.

The MoCA test for dementia has some advantages and disadvantages. The advantages include:

  • People can complete it via an app or using a pen and paper.
  • It is easy to use.
  • It can help identify those who may need more specialist assessments or treatments.
  • It is an objective test.
  • It is available in different languages and versions.
  • It is good for assessing a person’s cognitive abilities.

The disadvantages include:

  • Professionals require training to score the test.
  • A person’s level of education may affect the test.
  • Socioeconomic factors may affect the test.
  • People living with depression or other mental health issues may score similarly to those with mild dementia.
  • It is not suitable for discerning the type of dementia.

Below are the answers to some common questions about the MoCA test for dementia.

What is a normal MoCA score?

The cutoff for a normal MoCA score is 26. Scores of 25 and below may indicate mild cognitive impairment.

How accurate is the MoCA test?

The MoCA test may be able to detect mild cognitive impairment better than the older MMSE test.

A 2020 study found that although the MoCA test is good at determining whether a person performs thinking-based activities at a suitable level, it might not be as good at telling whether a person has impaired thinking.

Researchers have suggested that the test might be useful for determining those who may need more diagnostic tests and those who do not. However, they conclude that it might not be accurate or valuable for diagnosing cognitive impairment.

The MoCA test is a useful tool for examining a person’s cognitive functioning, meaning their ability to think.

Professionals may use the test to detect mild cognitive impairment and early signs of dementia. Dementia is a progressive condition that affects a person’s cognition.

The test examines a number of thinking processes, including calculations, awareness, language, short-term and working memory, attention span, and orientation. A person can take the test digitally through an app or complete it on paper.

The test takes about 10 minutes and does not discern the type of dementia.

A person should make an appointment with a healthcare professional if they feel as though they may benefit from a MoCA test or if they notice any symptoms that affect their ability to think and remember.