MoCA (Montreal Cognitive Assessment)

The Montreal Cognitive Assessment (MoCA), developed by Ziad Nasreddine and published in 2005, is a 30-point, 10-minute bedside screening tool covering visuospatial/executive function, naming, memory, attention, language, abstraction and orientation. Its sensitivity for detecting mild cognitive impairment (MCI) is substantially higher than the MMSE — approximately 90% in the original validation study (Nasreddine 2005), with a range of 80–100% across populations, versus 18–45% for the MMSE in clinic-based studies — making it the preferred first-line screen for subtle cognitive change. A score of 26 or above is conventionally considered normal, with one point added for fewer than 12 years of education, though this threshold has been debated given that scores are influenced by education, language proficiency and cultural background, requiring local normative data for valid interpretation. The MoCA is a screening instrument, not a diagnostic test; abnormal scores require further neuropsychological assessment.