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Moca Basic

The document outlines the Montreal Cognitive Assessment (MOCA-B), a tool used to evaluate cognitive function. It includes various sections assessing executive function, immediate recall, fluency, orientation, calculation, abstraction, delayed recall, visuoperception, naming, and attention. The assessment is scored out of a total of 30 points, with specific scoring criteria for each section.

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Paulina Martínez Bastidas
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341 views2 pages

Moca Basic

The document outlines the Montreal Cognitive Assessment (MOCA-B), a tool used to evaluate cognitive function. It includes various sections assessing executive function, immediate recall, fluency, orientation, calculation, abstraction, delayed recall, visuoperception, naming, and attention. The assessment is scored out of a total of 30 points, with specific scoring criteria for each section.

Uploaded by

Paulina Martínez Bastidas
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Name ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟

Sex ͟ ͟ ͟ ͟ ͟ Age ͟ ͟ ͟
MONTREAL COGNITIVE ASSESSMENT (MOCA-B) Education ͟ ͟ ͟ Date of exam ͟ ͟ ͟ ͟ ͟
BASIC Administered by ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟ ͟

EXECUTIVE FUNCTION SCORE


START
TIME

( /1)

IMMEDIATE RECALL ROSE CHAIR HAND BLUE SPOON No point


Perform 2 tri a ls even i f 1st trial
1st tri a l is s uccessful
2nd trial

FLUENCY Na me maximum numbers of FRUITS in 1 mi nute N items ( /2)


1.…………. 2.……………. 3.……………. 4.………….... 5.…………… 6.…………… 2 points if N = 13 or more
7.…………. 8.……………. 9.……………. 10.………….... 11.…………… 12.…………… 1 point if N = 8-12
0 point if N = 7 or less
13.…………. 14.……………. 15.……………. 16.………….... 17.…………… 18.……………

ORIENTATION [ ] time (± 2 hr) [ ] day [ ] month [ ] year [ ] place [ ] city ( /6)


CALCULATION Provi de 3 ways to pay using 1 dollar coins, 5 dollar and 10 dollar bills for a n object that costs exactly
“13 Dollars” (3 points if 3 ways, 2 points if 2 ways, 1 point if 1 way, 0 point if no correct way) ( /3)
[ ] 1…………………………… [ ] 2. ………………………… [ ] 3. …………………………

To wha t ca tegory these objects belong to ? ( e.g. ora nge - banana = frui t )
ABSTRACTION ( /3)
[ ] train - boat [ ] north - south [ ] drum - flute

ROSE CHAIR HAND BLUE SPOON


DELAYED RECALL Recall with
No cue [ ] [ ] [ ] [ ] [ ] ( /5)
Poi nts a re awarded for Recall with
[ ] [ ] [ ] [ ] [ ]
reca l l wi th No cue category cue
(1point for each item) Recall with
[ ] [ ] [ ] [ ] [ ]
multiple choice cue

VISUOPERCEPTION scissors T-shirt banana lamp candle 3 points if N = 9-10


( /3)
2 points if N = 6-8
Identify drawings. No more than 60 1 point if N = 4-5
watch cup leaf key spoon
0 point if N = 0-3 N ͟
s econds. See complementary s heet.

NAMING Identify a nimals. See complementary s heet. [ ] zebra [ ] peacock [ ] tiger [ ] butterfly ( /4)
Na me the numbers i n circles.
ATTENTION See complementary s heet. 15 8 392 03 9 4 0216 874675 ERROR ͟ ͟ N ( /1)
No point if 2 errors or more

Name the numbers in circles & squares : 3 8 5 1 3 0 2 9 2 0 4 9 7 8 6 1 5 76 4 ERROR ͟ ͟ N


2 points if 2 errors or less
( /2)
1 point if 3 errors
See complementary s heet. 1 5 8 3 9 20 3 9 4 0 2 1 6 8 7 4 6 7 5 0 point if 4 errors or more
END TIME

Adapted by : Parunyou Julayanont MD TOTAL SCORE ( /30)


Copyright : Z. Nasreddine MD Final Version June 04, 2014 Add 1 point if education < 4 year AND add 1 point if illiterate
TOTAL TIME ͟ ͟ ͟ ͟ ͟ min ͟ ͟ ͟ ͟ ͟ sec
MONTREAL COGNITIVE ASSESSMENT (MOCA-B)
BASIC COMPLEMENTARY WORKSHEET

VISUOPERCEPTION

NAMING

ATTENTION

Adapted by: Parunyou Julayanont MD Copyright: Z. Nasreddine MD Final Version June 04, 2014

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