| RPT |
|Montreal Cognitive Assessment Version 8.2 (MOCA_8.2)
| Gender: <.Patient_Gender.>
|
| MOCA_8.2 Total Score = <-Total->
| A score of 26 or greater is considered normal.
| Memory Index Score = <-MIS-> / 15
|
|Questions and Answers:
|
| 1. Alternating Trail Making. Correct Pattern:
| 1-A- 2- B- 3- C- 4- D- 5- E, without drawing any
|
| lines that cross. Any error that is not immediately
| self-corrected is scored incorrect.
| <*Answer_9436*>
| 2. Chair-Visuoconstructional Skills. Correct: All must be
| present: three-dimensional, all lines are drawn, no line
| is added, lines are relatively parallel and their length
| is similar.
| <*Answer_9437*>
| 3A. Clock face must be a circle with only minor distortion
| acceptable (e.g., slight imperfection on closing the circle).
| Date Given: <.Date_Given.>
| <*Answer_9438*>
| 3B. All clock numbers must be present with no additional numbers;
| numbers must be in the correct order and placed in the
| approximate quadrants on the clock face; Roman numerals are
| acceptable; numbers can be placed outside the circle contour.
| <*Answer_9439*>
| 3C. There must be two hands jointly indicating the correct time;
| the hour hand must be clearly shorter than the minute hand;
| hands must be centered within the clock face with their
| junction close to the clock center.
| Clinician: <.Staff_Ordered_By.>
| <*Answer_9440*>
| 4A. Snake or a type of snake like Boa or Cobra
| <*Answer_9441*>
| 4B. Elephant
| <*Answer_9442*>
| 4C. Crocodile or alligator
| <*Answer_9443*>
| 5A. Forward Digit Span.
| <*Answer_9444*>
| 5B. Backward Digit Span. Correct response for the backwards trial
| Location: <.Location.>
| is 2-4-7.
| <*Answer_9445*>
| 5C. Vigilance. Correct when there is zero to one errors (an error is
| a tap on a wrong letter or a failure to tap on letter A).
| <*Answer_9446*>
| 5D. Serial 7 subtraction starting at 70. Continue for five responses.
| <*Answer_9447*>
| 6A. Sentence repetition. The robber of the gray car was stopped by
| the police.
| <*Answer_9448*>
|
| 6B. Sentence repetition. The student went back to school without his
| books and pencils.
| <*Answer_9449*>
| 7. Words beginning with the letter S.
| <*Answer_9450*>
| 8A. Similarity between BED - TABLE.
| <*Answer_9451*>
| 8B. Similarity between LETTER - TELEPHONE.
| <*Answer_9452*>
| 9A. Recall HAND.
| Veteran: <.Patient_Name_Last_First.>
| <*Answer_9453*>
| 9B. Recall NYLON
| <*Answer_9454*>
| 9C. Recall PARK.
| <*Answer_9455*>
| 9D. Recall CARROT.
| <*Answer_9456*>
| 9E. Recall YELLOW.
| <*Answer_9457*>
| 10A. Today's date.
| SSN: <.Patient_SSN.>
| <*Answer_9458*>
| 10B. Current month
| <*Answer_9459*>
| 10C. Current year
| <*Answer_9460*>
| 10D. Day of the week
| <*Answer_9461*>
| 10E. What place is this?
| <*Answer_9462*>
| 10F. What city are we in?
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
| <*Answer_9463*>
| 11. Years of formal education:
| <*Answer_9464*>
|
|Information contained in this note is based on a self-report assessment
|and is not sufficient to use alone for diagnostic purposes. Assessment
|results should be verified for accuracy and used in conjunction with
|other diagnostic activities and procedures.
||Copyright (c) Z. Nasreddine MD
|
