Name : Date of birth :

MONTREAL COGNITIVE ASSESSMENT (MOCA) - Singapore Education : Date :

Sex : Examiner:

VISUOSPATIAL / EXECUTIVE POINTS

Copy Draw CLOCK (Ten past eleven)
cube ( 3 points )

10
10 2
End 2 3
9
9 4 3
8 1
Begin 4
8 7 6 5
5
7 6
[ ] [ ] [ ] [ ] [ ] __/5
Contour Numbers Hands
NAMING

[ ] [ ] [ ] __/3
MEMORY Read list of words, subject must FACE SILK CHURCH ROSE RED
repeat them. Do 2 trials, even if No
1st trial is successful. Do a recall 1st trial
points
after 5 minutes. 2nd trial
ATTENTION Read list of digits (1 digit/ sec.). Subject has to repeat them in the forward order [ ] 2 1 8 5 4
Subject has to repeat them in the backward order [ ] 7 4 2 __/2
Read list of numbers. The subject must tap with his hand at each number 1. No points if ≥ 2 errors
[ ] 62137811976216174511191796112 __/1
Serial 7 subtraction starting at 100 [ ] 93 [ ] 86 [ ] 79 [ ] 72 [ ] 65
4 or 5 correct subtractions: 3 pts, 2 or 3 correct: 2 pts, 1 correct: 1 pt, 0 correct: 0 pt __/3
LANGUAGE Repeat : I only know that John will help me today. [ ]
When dogs were in the room, the cat always hid under the bed. [ ] __/2
Fluency – Name as many animals as possible in one minute. [ ] _____ (N ≥ 11 words) __/1
ABSTRACTION Similarity between e.g. banana - orange = fruit [ ] train – bicycle [ ] watch - ruler __/2
DELAYED RECALL Has to recall words FACE SILK CHURCH ROSE RED Points for __/5
UNCUED
WITH NO CUE [ ] [ ] [ ] [ ] [ ] recall only
Category cue
Optional Multiple choice cue

ORIENTATION [ ] Date [ ] Month [ ] Year [ ] Day [ ] Place [ ] Country __/6

© Z.Nasreddine MD
Singapore Version (English) 30 September 2010
Cued Recall
Category Cue Multiple Choice
TOTAL __/30
Modified by Dong Yanhong and Christopher Chen Add 1 point if ≤ 6 yr edu
www.mocatest.org Face Part of the body Nose, Face, Hand
Silk Type of fabric Denim, Cotton, Silk
Church Type of building Church, School, Hospital
Rose Type of flower Daisy, Rose, Tulip
Red Type of colour Red, Blue, Green