Montreal Cognitive Assessment (MoCA)

Portuguese version

Montreal Cognitive Assessment (MoCA)
Mário R. Simões, Sandra Freitas, Isabel Santana, Horácio Firmino, Cristina Martins, Ziad Nasreddine, & Manuela Vilar (2008). PsyAssessmentLab, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra. Coimbra: Portugal.

Original version

Montreal Cognitive Assessment (MoCA)
Nasreddine, Z., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for Mild Cognitive Impairment. American Geriatrics Society, 53(4), 695-699.

Theoretical background

The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening instrument specifically developed to assess milder forms of cognitive impairment, allowing the global cognitive state to be ascertained rapidly. This screening test has been shown to be a very sensitive tool for this purpose, not only in the spectrum of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) (Freitas, Simões, Alves, & Santana, 2013) but also for cognitive impairment associated with many other clinical conditions (e.g. vascular cognitive impairment, Parkinson’s Disease, Huntington’s Disease, and tumors; see studies in http://www.mocatest.org). These results, which are consistently good as a measure of global cognitive function, have led to the widespread use of the MoCA in both clinical and research contexts. Its extensive validation, international recognition and recommendation in various guidelines make it a useful brief cognitive screening tool (Arnold et al., 2007; Gauthier et al., 2011; Hachinski et al., 2006). In Portugal the MoCA is recommended by the “Direcção Geral de Saúde” and the “Liga Portuguesa Contra a Epilepsia, as a screening test to be used.

Description

  • Assessment: brief assessment of cognitive impairment.
  • Type of instrument: Paper-and-pencil test, including oral and performance tasks.
  • Administration: individual administration 10 to 15 minutes.
  • Population: 25 years old or more.

Dimensions

The MoCA is a screening instrument which allows a global cognitive measurement to be made through the assessment of a wide range of cognitive functions, such as (i) short-term memory, (ii) executive functions, (iii) visuospatial abilities, (iv) language, (v) attention, concentration and working memory, and (vi) temporal and spatial orientation (Nasreddine et al., 2005).

Studies

After the translation and adaptation studies (Freitas, Simões, Martins, Vilar & Santana, 2010), as well as the normative study of the MoCA for the Portuguese population (Freitas, Simões, Alves & Santana, 2011), our research group has been conducting various validation studies. Some of these studies further emphasize the psychometric characteristics of the instrument: Influence of sociodemographic variables (Freitas, Simões, Alves & Santana, 2012); Construct validity (Freitas, Simões, Marôco, Alves & Santana, 2012); Item Response Theory - Rasch Model (Freitas, Prieto, Simões, & Santana, 2014) and Partial Credit Model (Freitas, Prieto, Simões, & Santana, 2015), while others studies mainly focus on specific clinical groups: MCI and AD (Freitas et al., 2013); Frontotemporal dementia (Freitas, Simões, Alves, Duro & Santana, 2012); Vascular dementia (Freitas, Simões, Alves, Vicente & Santana, 2012); Multiple Sclerosis (Freitas, Batista, Afonso, Simões, de Sousa, Cunha, & Santana, 2018).

Future research

The systematic research plan of the MoCA for the Portuguese population continues through several ongoing studies, namely: (i) the longitudinal study with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients; (ii) the correlation study with biomarkers of AD; (iii) clinical validation for Epilepsy and (iv) clinical validation for Acquired Immunodeficiency Syndrome (AIDS).

Funding

The studies of the MoCA for the Portuguese population supported by the Fundação para a Ciência e Tecnologia (Portuguese Foundation for Science and Technology; SFRH/BD/38019/2007 and SFRH/BPD/91942/2012, both to Sandra Freitas) and by the Fundação Calouste Gulbenkian (Calouste Gulbenkian Foundation) through the project "Memória, avaliação funcional e qualidade de vida: Estudos de validade e normas para a população portuguesa" (Memory, functional assessment and quality of life: Validation studies and norms for the Portuguese population; Proc. 74569, SDH-22 Neurosciences, 2010, PI, Mário R. Simões).

Contacts

Sandra Freitas (sandrafreitas0209@gmail.com)
Mário R. Simões (simoesmr@fpce.uc.pt)

References

PsyAssessment

1. Freitas, S. (2011). Envelhecimento e défice cognitivo: Estudos de adaptação, validação e normalização do Montreal Cognitive Assessment (MoCA) [Aging and cognitive impairment: Montreal Cognitive Assessment (MoCA) adaptation, validation and normative studies; PhD Thesis]. Dissertação de Doutoramento, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal. Publicado como e-book no repositório da Universidade de Coimbra.
2. Freitas, S., Batista, S., Afonso, A. C., Simões, M. R., de Sousa, L., Cunha, L. & Santana, I. (2018). Montreal Cognitive Assessment (MoCA) as a screening test for cognitive dysfunction in Multiple Sclerosis. Applied Neuropsychology: Adults, 25(1), 57-70. (doi:10.1080/23279095.2016.1243108).
3. Freitas, S., Prieto, G., Simões, M.R., & Santana, I. (2014). Psychometric properties of the Montreal Cognitive Assessment (MoCA): An analysis using the Rasch model. The Clinical Neuropsychologist, 28(1), 65-83. (doi:: 10.1080/13854046.2013.870231).
4. Freitas, S., Prieto, G., Simões, M.R., & Santana, I. (2015). Scaling cognitive domains of the Montreal Cognitive Assessment (MoCA): An analysis using the Partial Credit Model. Archives of Clinical Neuropsychology, 30(5), 435-447. (doi::10.1093/arclin/acv027).
5. Freitas, S., Simões, M. R., Alves, L., Duro. D., & Santana, I. (2012a). Montreal Cognitive Assessment (MoCA): Validation Study for Frontotemporal Dementia. Journal of Geriatric Psychiatry and Neurology, 25(3), 146-154. (doi: 10.1177/0891988712455235)
6. Freitas, S., Simões, M. R., Alves, L., & Santana, I. (2011). Montreal Cognitive Assessment (MoCA): Normative study for the Portuguese population. Journal of Clinical and Experimental Neuropsychology, 33(9), 989-996. (doi:10.1080/13803395.2011.589374).
7. Freitas, S., Simões, M. R., Alves, L., & Santana, I. (2012). Montreal Cognitive Assessment (MoCA): Influence of sociodemographic and health variables. Archives of Clinical Neuropsychology, 27, 165-175. (doi: 10.1093/arclin/acr116)
8. Freitas, S., Simões, M. R., Alves, L., & Santana, I. (2013). Montreal Cognitive Assessment (MoCA): Validation Study for Mild Cognitive Impairment and Alzheimer’s Disease. Alzheimer Disease and Associated Disorders, 27(1), 37-43. (doi: 10.1097/WAD.0b013e3182420bfe)
9. Freitas, S., Simões, M. R., Alves, L., & Santana, I. (2015). Montreal Cognitive Assessment (MoCA). In M. R. Simões, I. Santana & Grupo de Estudos de Envelhecimento Cerebral e Demência (GEECD) (Eds.), Escalas e testes na demência (3ª ed., Vol.1, pp.24-31) [Scales and tests in dementia]. Lisboa: Novartis.
10. Freitas, S., Simões, M. R., Alves, L., Vicente, M., & Santana, I. (2012). Montreal Cognitive Assessment (MoCA): Validation Study for Vascular Dementia. Journal of International Neuropsychology Society, 18(6), 1031-1040. (doi: 10.1017/S135561771200077X)
11. Freitas, S., Simões, M. R., Marôco, J., Alves, L., & Santana, I. (2012). Construct validity of the Montreal Cognitive Assessment (MoCA). Journal of International Neuropsychology Society, 18, 242-250. (doi: 10.1017/S1355617711001573)
12. Freitas, S., Simões, M. R., Martins, C., Vilar, M., & Santana, I. (2010). Estudos de adaptação do Montreal Cognitive Assessment (MoCA) para a população portuguesa [Montreal Cognitive Assessment (MoCA): Portuguese adaptation studies]. Avaliação Psicológica, 9(3), 345-357.
13. Freitas, S., Simões, M. R., & Santana, I. (2014). Montreal Cognitive Assessment (MoCA): Pontos de corte no Défice Cognitivo Ligeiro, Doença de Alzheimer, Demência Frontotemporal e Demência Vascular [Montreal Cognitive Assessment (MoCA): Cut-off points in Mild Cognitive Impairment, Alzheimer Disease, Frontotemporal Dementia and Vascular Dementia]. Sinapse,14(1), 18-30.
14. Freitas, S., Simões, M. R., & Santana I. (2014). Estudos de adaptação, validação e normalização do Montreal Cognitive Assessment (MoCA) para a população portuguesa [Montreal Cognitive Assessment (MoCA): Portuguese adaptation, validation and normative studies]. In L. S. Almeida, M. R. Simões & M. M. Gonçalves (Eds.), Instrumentos e contextos de avaliação psicológica (1ª ed., Vol. II, pp.251-282) [Instruments and contexts of psychological assessment]. Coimbra: Almedina Edições.
15. Simões, M. R., Freitas, S., Santana, I., Firmino, H., Martins, C., Nasreddine, Z., & Vilar, M. (2008). Montreal Cognitive Assessment (MoCA): Manual - Versão final portuguesa [MoCA: Manual – final version]. Coimbra: Serviço de Avaliação Psicológica, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra.

Other references

Nasreddine, Z., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for Mild Cognitive Impairment. American Geriatrics Society, 53(4), 695-699.