Montreal Cognitive Assessment (MoCA)
A 30-point cognitive screen that detects mild cognitive impairment in about 10 minutes.
By Claire White
- Clinician-administered; about 10 minutes.
- 30 points across seven scored sections. One point is added for 12 or fewer years of education, and the total is still capped at 30.
- 26 and above is the normal range published by MoCA Test Inc. Later work argues that 23 is the better cutoff.
- Published by MoCA Test Inc.
Psychometrics
Screening accuracy at a cutoff of 26, and reliability, from the original validation (Nasreddine et al., 2005). Higher is better.
What does the MoCA measure?
MoCA Test Inc. describes the test as covering six cognitive domains: short-term memory, visuospatial ability, executive function, attention with concentration and working memory, language, and orientation to time and place. On the form these are collected into seven scored sections that add to 30 points. Visuospatial and executive function is worth 5, naming 3, attention 6, language 3, abstraction 2, delayed recall 5, and orientation 6.
It was written to catch what the Mini-Mental State Examination misses. The MMSE was built to detect dementia, and it is not sensitive at the mild end, where a person is still independent but the family has noticed something. That gap is what the MoCA was designed to close.
What does a MoCA score mean?
The total runs from 0 to 30, where higher is better. MoCA Test Inc. publishes four bands.
| Total score | Band |
|---|---|
| 26 to 30 | Normal cognitive performance |
| 18 to 25 | Mild impairment |
| 10 to 17 | Moderate impairment |
| 0 to 9 | Severe impairment |
The cutoff at 26 comes from the 2005 validation. It is contested. A 2018 re-examination found that 26 produces an inflated rate of false positives, particularly in older people and people with fewer years of formal education, and that a cutoff of 23 gave the best diagnostic accuracy across a range of parameters. Both are in current use, so the threshold applied to a given result depends on the clinic and the population.
One point is added for 12 or fewer years of formal education, and the total is still capped at 30. A score below the cutoff is a reason to look further, not a diagnosis. It is reference information for the care team, tracked over time.
How the MoCA is administered
- Administered by
- Any clinician, care provider, or researcher following the official administration and scoring instructions
- Time to administer
- About 10 minutes
- Equipment
- The score sheet, a pen or pencil, and a watch for the timed items
- Cost
- Free to take here.
- Published by
- MoCA Test Inc.
- Training required
- Certification is optional when the total score is used for screening, triage, or referral, and required to interpret individual tasks, sub-scores, or specific domains. Free for students, faculty, academic researchers, and staff of publicly operated health institutions.
- Age range
- Adults
- Available languages
- Close to 100 languages on paper. The app is in five, according to MoCA Test Inc.
The MoCA is copyright MoCA Test Inc. The items, prompts, and scoring sheet are not reproduced here. The official forms and instructions come from mocacognition.com.
Which conditions is the MoCA used for?
Related instruments
- Edinburgh Cognitive and Behavioural ALS Screen (ECAS)The equivalent screen built for ALS, where the writing and speaking the MoCA asks for get in the way
- MDS-UPDRS Part IRates cognitive impairment as one of the non-motor experiences of daily living in Parkinson's
- FOUR ScoreWhat gets used before someone is awake enough to sit a cognitive screen
MoCA questions, answered
How is the MoCA scored?
Out of 30, across seven scored sections: visuospatial and executive function worth 5 points, naming worth 3, attention worth 6, language worth 3, abstraction worth 2, delayed recall worth 5, and orientation worth 6. One point is added if the person has 12 or fewer years of formal education, but the total is still capped at 30, so someone who already scored 30 gets no adjustment.
What is a normal MoCA score?
MoCA Test Inc. publishes 26 and above as normal cognitive performance, 18 to 25 as mild impairment, 10 to 17 as moderate, and 0 to 9 as severe. That 26 comes from the original 2005 validation. A 2018 re-examination found that 26 produces too many false positives, especially in older people and people with less formal education, and that 23 gave the best diagnostic accuracy. Both numbers are in current use, so the cutoff your clinician applies may not be the one printed on the form.
How long does the MoCA take?
About 10 minutes. It was designed as a 10-minute screen, which is what made it practical in a general clinic rather than a neuropsychology suite.
Is the MoCA free?
Yes. It is free to take here. The MoCA itself is published by MoCA Test Inc., which is who to approach about administering it in your own practice.
Do you need certification to administer the MoCA?
It depends what you do with the result. As of December 2025, MoCA Test Inc. makes certification optional for health professionals who use the test only for screening, triage, or referral and interpret nothing beyond the total score. Certification is still required to interpret individual tasks, sub-scores, or domain-specific impairment. Neuropsychologists and clinicians who have completed a one-year post-doctoral cognitive fellowship are exempt. The training runs about an hour and is free for students, faculty, academic researchers with ethics approval, and staff of publicly operated health institutions.
What is the difference between the MoCA and the MMSE?
Sensitivity at the mild end. In the original validation both tests were given to the same people. The MoCA identified 90 percent of those with mild cognitive impairment and the MMSE identified 18 percent. The trade is specificity: the MMSE was 100 percent specific in that sample and the MoCA 87 percent, which is the same tendency to false positives that later work addressed by lowering the cutoff.
Does the MoCA diagnose dementia?
No. It is a screen. A score below the cutoff is a reason for fuller assessment, not a diagnosis, and the result is reference information for you and your clinician.
Evidence, psychometrics and provenance
Created by Ziad Nasreddine and colleagues and published in 2005 in the Journal of the American Geriatrics Society. It is owned by MoCA Test Inc. Beyond Parkinson’s disease and stroke it is used as a cognitive screen in epilepsy, where one study found impairment on the MoCA in 60 percent of people with cryptogenic epilepsy whose MMSE score was normal.
- Sensitivity for mild Alzheimer's disease
- 100 percent at the same cutoff (Nasreddine et al., 2005)
- The MMSE on the same sample
- 18 percent sensitivity for MCI, against 90 percent for the MoCA (Nasreddine et al., 2005)
- Cutoff under revision
- 23 gave the best diagnostic accuracy in a 2018 re-examination (Carson et al.)
References
- 1.Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699.
- 2.Carson N, Leach L, Murphy KJ. A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores. Int J Geriatr Psychiatry. 2018;33(2):379-388.
- 3.Phabphal K, Kanjanasatien J. Montreal Cognitive Assessment in cryptogenic epilepsy patients with normal Mini-Mental State Examination scores. Epileptic Disord. 2011;13(4):375-381.
- 4.MoCA Test Inc. Score interpretation, permissions, and training and certification policy. mocacognition.com.
This assessment uses a validated instrument and is reference information, not a diagnosis.