| RPT |
.| .| Montreal Cognitive Assessment, Alternate 2| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>| SSN: <.Patient_SSN.>|
<*Answer_5653*>| 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_5654*>| 5D. Serial 7s starting at
80. Continue for five responses.| <*Answer_5655*>| 6. Language| 6A. Sentence repetition. She heard his lawyer was the one to sue after the accident.| <*Answer_5656*>| 6B. Sentence
repetition. The little girls who were given too much candy got stomach aches.| <*Answer_5657*>| 7. Words beginning with the letter B.| <*Answer_5658*>| 8. Abstraction| 8A. Similarity
between EYE - EAR.| <*Answer_5659*>| 8B. Similarity between TRUMPET - PIANO.| <*Answer_5660*>| 9. Delayed recall| 9A. Recall TRAIN| <*Answer_5661*>| 9B. Recall EGG.|
<*Answer_5662*>| 9C. Recall HAT.| <*Answer_5663*>| 9D. Recall CHAIR.| <*Answer_5664*>| 9E. Recall BLUE.| <*Answer_5665*>| 10. Orientation| 10A. Today's date,|
<*Answer_5666*>| 10B. Current month| <*Answer_5667*>| 10C. Current year| <*Answer_5668*>| 10D. Day of the week| <*Answer_5669*>| 10E. What place is this?| <*Answer_5670*>|
10F. What city are we in?| <*Answer_5671*>| 11. Years of formal education:| <*Answer_5672*>| | Copyright (c) Z. Nasreddine MD| | 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.| $~
DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | MoCA Score: <-MoCA Score->| A score of 26 or greater is considered normal.| | | 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_5644*>| 2. Cylinder-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_5645*>| 3. Draw a clock| 3A. Clock face must be a circle with only minor distortion acceptable (e.g., slight imperfection on closing the circle).| <*Answer_5646*>|
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_5647*>| 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. | <*Answer_5648*>| 4. Name pictured animals| 4A. Donkey| <*Answer_5649*>| 4B. Pig|
<*Answer_5650*>| 4C. Kangaroo| <*Answer_5651*>| 5. Attention| 5A. Forward Digit Span.| <*Answer_5652*>| 5B. Backward Digit Span. Correct response for the backwards trial is 1-7-4.|
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