MoCA
COGNITIVE ASSESSMENT
PATIENT – FAMILY BROCHURE
TABLE OF
CONTENTS
05 WHAT IS MoCA?
06 WHO CAN ADMINISTER MoCA?
07 SCREENING AND DIAGNOSIS
07 WHAT DOES THE MoCA SCORE MEAN?
08 WHY MoCA?
09 WHAT IS MILD COGNITIVE IMPAIRMENT?
10 SIGNS AND SYMPTOMS OF MCI
11 WHY IT IS IMPORTANT TO CARE
13 MANAGING COGNITIVE DECLINE
18 PREPARING FOR THE FUTURE
19 TREATMENT AND RESEARCH
WHAT IS
MoCA?
MoCA is a short interactive test
that accurately assesses multiple
cognitive domains:
Short-term memory
(e.g., remembering new information)
Visuospatial abilities
(e.g., drawing; identifying spatial
relationship among items)
Executive functions
(e.g., planning; problem solving)
Attention, concentration and working memory
(e.g., multi-step tasks)
Language
(e.g., finding appropriate word)
Orientation to time and place
(e.g., remembering date; knowing current location)
5
WHO CAN
ADMINISTER MoCA?
Any healthcare worker who has completed MoCA’s official training
and certification program can administer the test. However,
only medical professionals with specific training in cognition can
interpret the results or make a diagnosis.
Medical professionals who have successfully completed MoCA’s
mandatory training and certification module have a unique MoCA ID
number, which assures their competency in explaining, administering
and scoring MoCA.
6
SCREENING
AND DIAGNOSIS
MoCA is a screening tool used by healthcare professionals as a
first step to detect evidence of cognitive impairment. With proper
administration and scoring, MoCA results should reflect your
cognitive performance accurately. As a screening tool, MoCA is not
designed to diagnose a specific condition or disease.
If the medical professional administering MoCA notes a low score
or observes certain issues, the patient may be referred for further
consultation, including complete neuropsychological evaluation,
blood tests and imaging exam to diagnose the disease or condition.
WHAT DOES THE MOCA SCORE MEAN?
MoCA scores range from 0 to 30, with 26 or higher being
considered normal (i.e., no cognitive issues apparent)
Scoring less than 26 does not necessarily mean there are any
cognitive issues present. However, a low score would result
in further evaluation.
7
WHY
MoCA?
MoCA is renowned and favored by medical professionals for its
high sensitivity to detect early stages of cognitive decline and Mild
Cognitive Impairment (MCI).
MoCA is the most validated cognitive screening tool for detection
of MCI, based on over 500 independent peer-reviewed scientific
studies comparing it to other screening tools.
Because of its high sensitivity and validity, MoCA is also a standard
scale used in scientific research. MoCA has been referenced over
15,000 times in published medical studies.
8
WHAT IS MILD
COGNITIVE
IMPAIRMENT?
Mild cognitive impairment (MCI) is a condition in which a person
experiences a slight—but noticeable—decline in mental abilities
(memory and thinking skills) compared with others of the same
age. The minor decline in abilities is noticeable by the person
experiencing them or by others who interact with the person, but
the changes are not severe enough to interfere with normal daily
life and activities.
MCI can be associated with Alzheimer’s Disease and dementia,
but it could also relate to other disease or non-disease conditions.
Parkinson’s disease, diabetes, COVID, head trauma, drug side effect,
depression and stress are among the many potential causes of mild
cognitive impairment.
(Source: www.clevelandclinic.org) 9
SIGNS AND
SYMPTOMS OF MCI
Although some cognitive decline is expected in healthy aging—such
as occasional forgetfulness or slower mental processing—MCI would
entail frequently occurring forgetfulness or thinking skills that are
noticeably diminished compared to peers of the same age.
Signs of MCI may include,
among other things, regularly:
forgetting appointments
having trouble coming up with the right word
losing train of thought
making poor decisions
getting lost
10
WHY IT IS IMPORTANT
TO CARE
Many MCI-related conditions are treatable or manageable.
In general, the earlier a condition is detected, the better
a patient’s potential outcome can be. MCI screening is
therefore important to ensure the earliest possible detection
and best possible outcomes.
From a personal health perspective, steps can still be taken to
manage non-treatable conditions. In terms of interpersonal,
professional and financial matters, earlier detection and
awareness of MCI can allow for better decision making and
limit challenges for the patient and related parties.
11
MANAGING
COGNITIVE
DECLINE
ORGANIZATIONAL SKILLS
AND ROUTINES
Useful organizational tactics reduce reliance on
memory and can limit stress and frustration. For
example, having a specific hook by the door to
hang your keys avoids the potential of misplacing
them.
Developing habits and routines also helps certain
tasks become nearly automatic and less reliant
on memory. For example, vacuuming after dinner
every Monday or bringing in the mail every day
after breakfast.
Here are some other tips:
Install a whiteboard in the home and carry a pocket journal for
daily or weekly to-do lists. Note items in chronological order and
cross out when completed.
Program alarm clocks or timers to ring when it is time to do a
certain task or to leave the house
Use sticky notes (Post-it) as reminders. Strategically place these
by the entrance door or on the fridge.
Do tasks as soon as they come to mind. For example, If you
remember that you must make a payment, do so immediately
to avoid forgetting.
13
PHYSICAL ACTIVITY
It is well known that physical exercise has positive effects on the
muscles, lungs, and heart. However, it is important to remember that
physical activity also has significant benefits for cognition. In fact,
many studies have shown physically active individuals to perform
better on cognitive tasks than sedentary individuals.
The World Health Organization recommends a minimum of 2.5 hours
of moderate physical activity per week for adults over 65. This could
be 30 minutes of physical activity, five times per week.
We understand that exercise increases the amount of oxygen transported
to the brain, which results in better cognitive performance.
14
Specifically, through exercise:
New brain cells are developed that support
better memory
Brain volume increases benefiting information
processing and retention
Blood circulation improves artery health and
reduces risk of stroke and vascular dementia
Rates of depression decrease,
which are correlated with MCI
15
COGNITIVE ACTIVITY
To support brain health, it is important to commit
to stimulating cognitive activities every day. Tasks
or activities requiring mental effort are exercise
for the brain.
Certain activities require only minor cognitive
effort, such as driving a car which is done almost
automatically from a cognitive perspective. Other
activities which are more cognitively demanding
are beneficial for brain health. Examples include
playing chess, reading a novel, watching
educational programs, writing letters, taking a
class, and learning a skill.
Some important points:
The intellectual challenge that activity
represents for the individual is more important
than the activity selected
Dedicate substantial time for cognitive activity
and add it to a daily schedule
Practice a variety of different
cognitive activities
Choose activities which are enjoyable
to encourage participation.
16
MEDITERRANEAN DIET
Research has also demonstrated diet is not only an important factor
for physical health, but for brain health as well. The Mediterranean
Diet, in combination with physical and brain exercise, is recommended
for limiting cognitive decline.
In summary, this diet includes:
Eating vegetables, fruits, and whole grains every day
Eating fish, poultry, beans, and eggs a few times per week
Moderate portions of dairy
Limited consumption of red meat
Enjoying red wine in moderation
Eating with friends and family to benefit mood, have stimulating
conversations, and build interpersonal connections
17
PREPARING FOR
THE FUTURE
It is always a good idea to determine and document personal wishes
before one is unable to do so. If someone is experiencing cognitive
decline, from any cause, it is important to assess if they have legal
capacity to make decisions and plan for their future.
If a specialized medical professional determines that an individual
is experiencing cognitive decline and still has legal capacity, they
should participate in important planning decisions, as soon as
possible, relating to:
Home living situation
Home care or facility care
Property, investments and loans
Estate planning
Assigning power of attorney for future decisions
For legal questions relating to estate or designating power of
attorney, contact a reputable lawyer in your area who is specialized
in elder law or estate planning.
18
TREATMENT
AND RESEARCH
Many conditions and diseases that cause MCI have proven
treatment options and therefore with medical intervention symptom
progression can be slowed down, stopped, or reversed—especially
with early detection and intervention.
Certain conditions or diseases, unfortunately, do not yet have widely
applied treatment options. However, as discussed earlier proper diet,
regular exercise, and daily cognitive stimulation can manage cognitive
decline. Furthermore, scientific research is consistently developing
and testing new treatment options for various conditions—this is a
first step toward a new approved treatment.
To learn about or participate
in treatment trials visit:
www.clinicaltrials.gov
19
The most sensitive and validated cognitive screening tool
mocatest.org
