MoCA — Montreal Cognitive Assessment 🧠
Interactive Montreal Cognitive Assessment (MoCA v7.1) with trail making, clock drawing, memory, attention, language, abstraction, delayed recall, and orientation scoring.
Montreal Cognitive Assessment (MoCA)
Version 7.1 — interactive administration & scoring worksheet
Total
0/30
For validated clinical use, register and download the official form at mocacognition.com. This tool supports bedside administration and auto-scoring.
Examiner
Ask the patient to draw a line, going from a number to a letter in ascending order.
Begin at 1 — draw a line from 1 to A, then to 2, then to B, and so on. End at E.
Sequence: 1 → A → 2 → B → 3 → C → 4 → D → 5 → E.
Score: 1 point if completed without error or uncrossed lines.
Trail making — practice layout (tap in order on screen, or use paper)
Examiner
Say: “Copy cube.”
Hand the patient paper and pen; they copy the drawing below.
Score: 1 point if the cube is drawn correctly (3-D, all lines parallel, no extra lines).
Copy cube
Patient copies the 3D cube drawing
Examiner
Say: “Draw a clock. Indicate all of the numbers and the time ten past eleven.”
Hand the patient paper and pen.
Score: 3 points total — contour (1 pt): circle drawn; numbers (1 pt): all present and in correct positions; hands (1 pt): two hands, time reads ten past eleven.
Draw clock — ten past eleven
Score contour, numbers, and hands separately (3 pts total)
Examiner
Point to each animal in turn and ask: “Tell me the name of this animal.”
Use the official MoCA stimuli (lion, rhinoceros, camel) where possible.
Score: 1 point for each correct response (3 points total).
Examiner
Say: “I am going to read you a list of words that you will have to remember. Listen carefully. When I am through, tell me all the words you can remember. It doesn’t matter in what order you say them.”
Read aloud at one word per second: FACE · VELVET · CHURCH · DAISY · RED.
After the patient recalls, say: “Tell me all the words you can remember.”
Do 2 trials, even if the 1st trial is successful. Delayed recall is tested after 5 minutes (see below).
Score: No points for learning trials — score only delayed recall.
| Trial | FACE | VELVET | CHURCH | DAISY | RED |
|---|---|---|---|---|---|
| 1 trial | |||||
| 2 trial |
Examiner
Read the list of digits at one digit per second.
Say: “I am going to read you some numbers. When I am through, repeat them in the same order.”
Digits: 2 · 1 · 8 · 5 · 4
Score: 1 point if repeated correctly in forward order.
Examiner
Say: “I am going to read you some numbers. When I am through, repeat them in the backward order.”
Digits: 7 · 4 · 2
Score: 1 point if repeated correctly in backward order.
Examiner
Read the list of letters at one letter per second.
Say: “Tap with your hand at each letter A.”
Letters: F · B · A · C · M · N · A · A · J · K · L · B · A · F · A · K · D · E · A · A · A · J · A · M · O · F · A · A · B
Score: 1 point if no errors, or only one error. No points if ≥ 2 errors.
Examiner
Say: “Now I will ask you to subtract 7 from 100, and then keep subtracting 7 from your answer until I tell you to stop.”
Record each answer. Stop after five subtractions (or when the patient cannot continue).
Score: 3 pts: 4–5 correct; 2 pts: 2–3 correct; 1 pt: 1 correct; 0 pts: none correct.
Serial 7s from 100 (3 pts: 4–5 correct; 2 pts: 2–3; 1 pt: 1)
0 correct → 0 pts
Examiner
Read each sentence aloud exactly as written. Ask the patient to repeat it after you.
Do not repeat the sentence unless asked once.
Score: 1 point per sentence repeated correctly (2 points total).
Examiner
Say: “Tell me as many words as you can that begin with the letter F.”
Allow one minute. Do not count proper names (e.g. people, places) or the same word twice.
Score: 1 point if ≥ 11 words in one minute.
Examiner
Say: “Tell me how an X and a Y are alike.”
Example for the patient: “Banana and orange — both are fruits.”
Ask: train – bicycle, then watch – ruler.
Score: 1 point each for an acceptable abstract similarity (e.g. modes of transport; measuring instruments).
Examiner
After approximately 5 minutes (and other MoCA tasks), ask:
“Tell me the five words you learned earlier.”
Has to recall words with no cue.
Score: 1 point for each word freely recalled (5 points total).
Optional cue tracking (no points)
Category cue
Multiple choice cue
Examiner
Ask the patient:
“What is the date?” · “What is the month?” · “What is the year?”
“What is the day of the week?” · “What place is this?” · “What city are we in?”
Score: 1 point for each correct answer (6 points total).
Likely significant cognitive impairment — arrange formal neuropsychology / memory clinic review.
Normal ≥26/30 · Add 1 pt if ≤12 years education
Overview
- The Montreal Cognitive Assessment (MoCA) is a brief screening tool for mild cognitive impairment and early dementia.
- It assesses visuospatial/executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation.
- A score of 26 or above (out of 30) is generally considered normal; add 1 point if the patient has 12 or fewer years of formal education.
- MoCA is more sensitive than MMSE for detecting mild cognitive impairment, particularly in educated patients.
When to use
- Suspected cognitive decline, memory complaints, or difficulty with ADLs in older adults.
- Screening before or after stroke, delirium, or major surgery when baseline cognition is unclear.
- Monitoring cognitive change over time (use the same version and language where possible).
- Not a standalone diagnosis. Abnormal scores warrant further assessment (MMSE, ACE-III, neuropsychology, imaging as indicated).
Administration tips
- Allow the patient adequate time; avoid interrupting during recall tasks.
- Complete two learning trials for the memory word list even if the first trial is successful.
- Start the 5-minute delayed recall timer after the memory learning phase.
- For serial 7s, score each response as 7 less than the patient's previous answer (starting from 100).
- Use the official MoCA form and register at mocacognition.com for validated clinical use.
References
Educational reference only. Medical disclaimer