MoCA — MRCPsych Paper B MCQ

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ModerateOld Age PsychiatryMoCAMRCPsych Paper B

A cognitive screening instrument takes approximately 10 minutes and is scored out of 30. It includes alternating trail-making, cube copying, clock drawing and five-word delayed recall, with category and multiple-choice cues recorded after free recall. Which instrument is described?

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Correct answer: C — Montreal Cognitive Assessment (MoCA)

The correct answer is C, the Montreal Cognitive Assessment (MoCA). It is a brief 30-point multidomain cognitive screen developed to improve detection of mild cognitive impairment. Its characteristic visuospatial and executive tasks include alternating trail-making, cube copying and clock drawing; memory assessment includes five-word delayed free recall followed by category and recognition cues. The MMSE is also scored out of 30 but does not contain this combination of executive and visuospatial tasks. The ACE-III is a longer 100-point assessment. The CDT assesses clock drawing rather than multiple cognitive domains, while the RUDAS uses a different set of culturally minimised tasks. The original MoCA validation used a cutoff of 26, but a screening score should be interpreted in clinical and demographic context rather than treated as diagnostic by itself.

Reference: Royal College of Psychiatrists, Clinical assessment of dementia: Popular global cognitive assessment tools, Table 1, hosted 2024 (source article 2015): https://www.rcpsych.ac.uk/docs/default-source/events/free-webinars/2024/grand-round-14-march/calc---clinical-assessment-of-dementia---14-march-2024.pdf