Neurodegenerative diseases constitute a major public health problem due in particular to the cognitive disorders that characterize them. Among the many existing tests used to identify cognitive decline, we find the MoCA or “Montreal Cognitive Assessment”.

Alzheimer’s disease (AD) is the most common neurodegenerative disease in people over the age of 65. It is manifested by a progressive deterioration of cognitive functions, in particular memory, with a significant impact on activities of daily living. 

In France, nearly 800 people are believed to be affected by AD or a related disease. This represents a considerable human, social and financial cost. Their care becomes more than ever a public health issue. However, in France, 000% of cases of dementia are not the subject of specific diagnostic procedures with confirmation by a specialist. Much work has focused in recent years on patients with mild cognitive impairment or “Mild Cognitive Impairment” (MCI). The latter is characterized by the presence of a slight cognitive impairment, especially in the memory area, in patients who remain independent in daily life (Petersen et al., 50).

Screening for MCI requires the use of one or more rapid, simple tests for which the required metrological (measurement) qualities have been validated. Developed in 2005 by Dr. Ziad Nasreddine, a Canadian neurologist, the MoCA is a test intended for adults and elderly people with suspected mild cognitive impairment, mild dementia or neurodegenerative disease. In 80% of cases, it is used to screen for Alzheimer’s disease, especially when the person often misses it, is sometimes disoriented. It has been used for twenty years in 200 countries and available in 20 languages. It does not make it possible to establish a diagnosis but is mainly used to direct towards other examinations. It has also received empirical attention for its ability to detect cognitive impairment in people with Parkinson’s disease.

Lasting 10 to 15 minutes, the test consists of evaluating mild to moderate cognitive dysfunctions, by evaluating the following functions: 

• attention;
• concentration ;
• executive functions;
• Memory ;
• language ;
• visuo constructive skills;
• abstraction capacities;
• the calculation;
• orientation.  

The examiner gives a quiz that requires short answers, ten tasks like drawing a cube, a clock and a memory exercise with different words to remember. 

The instructions are specific enough to clearly guide the assessor throughout the award. He must therefore have the scoring grid and the instructions for completing the MoCA in hand. With these two documents and a pencil, he proceeds to the test by following the instructions and simultaneously rating the person’s answers. Since the MoCA score depends on the level of education, the authors recommend adding a point if the patient’s education is 12 years or less. While the questions may seem easy, they are not easy for people with dementia.

The exercises are based on:

• short-term memory (5 points);
• visual and spatial abilities with the clock test (3 points);
• a task constituting to copy a cube (1 point);
• executive functions;
• phonemic fluence (1 point);
• verbal abstraction (2 points);
• attention, concentration and working memory (1 point);
• series subtraction (3 points);
• reading numbers right side up (1 point) and backwards (1 point);
• language with the presentation of pets (3 points) and repetition of complex sentences (2 points);
• orientation in time and space (6 points).

The rating of the evaluation is done directly on the grid and simultaneously with the test. The assessor must record the person’s answers and mark them (good for one point and incorrect for 0 points). A maximum score out of 30 points will thus be obtained. The score can be interpreted as follows:

• = 26/30 = no neurocognitive impairment;
• 18-25 / 30 = slight impairment;
• 10-17 = moderate impairment;
• Less than 10 = severe impairment.