MoCA Version 8.1 June 28, 2017
© Z. Nasreddine MD www.mocatest.org
them to me in the backward order.” The examiner reads the three number sequence at a
rate of one digit per second. If the subject repeats the sequence in the forward order, the
examiner may not ask the subject to repeat the sequence in backward order at this point.
Scoring: One point is allocated for each sequence correctly repeated (N.B.: the correct
response for the backward trial is 2-4-7).
Vigilance: Administration: The examiner reads the list of letters at a rate of one per
second, after giving the following instructions: “I am going to read a sequence of letters.
Every time I say the letter A, tap your hand once. If I say a different letter, do not tap
your hand.”
Scoring: One point is allocated if there is zero to one error (an error is a tap on a wrong
letter or a failure to tap on letter A).
Serial 7s: Administration: The examiner gives the following instructions: “Now, I will
ask you to count by subtracting 7 from 100, and then, keep subtracting 7 from your
answer until I tell you to stop.” The subject must perform a mental calculation, therefore,
(s)he may not use his/her fingers nor a pencil and paper to execute the task. The examiner
may not repeat the subject’s answers. If the subject asks what her/his last given answer
was or what number (s)he must subtract from his/her answer, the examiner responds by
repeating the instructions if not already done so.
Scoring: This item is scored out of 3 points. Give no (0) points for no correct
subtractions, 1 point for one correct subtraction, 2 points for two or three correct
subtractions, and 3 points if the subject successfully makes four or five correct
subtractions. Each subtraction is evaluated independently; that is, if the subject responds
with an incorrect number but continues to correctly subtract 7 from it, each correct
subtraction is counted. For example, a subject may respond “92 – 85 – 78 – 71 – 64”
where the “92” is incorrect, but all subsequent numbers are subtracted correctly. This is
one error and the task would be given a score of 3.
7. Sentence repetition:
Administration: The examiner gives the following instructions: “I am going to read you a
sentence. Repeat it after me, exactly as I say it [pause]: I only know that John is the one
to help today.” Following the response, say: “Now I am going to read you another
sentence. Repeat it after me, exactly as I say it [pause]: The cat always hid under the
couch when dogs were in the room.”
Scoring: One point is allocated for each sentence correctly repeated. Repetitions must be
exact. Be alert for omissions (e.g., omitting "only"), substitutions/additions (e.g.,
substituting "only" for "always"), grammar errors/altering plurals (e.g. "hides" for "hid"),
etc.
8. Verbal fluency:
Administration: The examiner gives the following instructions: “Now, I want you to tell
me as many words as you can think of that begin with the letter F. I will tell you to stop
after one minute. Proper nouns, numbers, and different forms of a verb are not permitted.
Are you ready? [Pause] [Time for 60 sec.] Stop.” If the subject names two consecutive