“In an effort to disprove theories that he is mentally unfit and in cognitive decline, President Trump passed a voluntary cognitive assessment test Friday meant to assess his mental reflexes,” according to a White House doctor.
As part of his presidential medical checkup, Donald Trump’s was given the Montreal Cognitive Assessment (MoCA) test, a well-known and well- tested screening tool to quickly detect cognitive dysfunction. According to the doctor, “President Trump did "exceedingly well" on a cognitive screening, used to detect early signs of memory loss and other neurologic functions.”
What Was the Doctor Looking For?
MoCA was designed by a neurologist as a rapid screening instrument for health professionals to test for mild cognitive dysfunction. There are several neurological and systemic diseases - Alzheimer’s Disease (AD), Vascular Cognitive Impairment, Parkinson’s disease, Lewy Body - that are accompanied by cognitive impairment (CI).
What Does the MoCA Test Look Like?
According to the test instructions, the 30-point test takes about 10 minutes and asks the patient to perform a simple batch of memory and mental tasks. MoCA is available in 100 countries in 46 different languages and dialects.
See a few samples of the MOCa questions below the image:
In layperson's terms...
Visuospatial- Executive Skills The patient is asked to draw a clock and put numbers on it.
Draw a Cube
Naming The patient is tested on naming and is asked give the name of animals in the order drawn on a test page.
Attention Repeat numbers in the order that they hear them, repeat another set of numbers backward, read a list of letters and every time they say the letter A, the patient will tap once.
Math Skills Count by subtracting seven from 100 and keep subtracting seven. Based on the results, subtract seven again. Do this a total of four times.
Sentence Repetition The examiner will read a sentence and the patient repeats it.
Verbal Fluency Patient to say as many words that begin with a single letter.
Abstract Thought Explain what a certain pair of words have in common. For example:
If a banana and an orange are fruit then what are a train and bicycle?
Delayed Recall Patient asked to remember as many words as possible. The doctor will circle back later in exam and ask for the word list. To decrease the learning effect from taking the MoCA many times over a short time period, alternate versions have been made available. In addition, an electronic version for tablets now increases measurement precision and helps to monitor the progress of the disease.
Who can interpret the MoCA? Only a health professional with expertise in the cognitive field may interpret the results.
What do the MoCA Scores Show? The total possible score is 30 points; a score of 26 or above is considered normal. The following score ranges may be used to grade the severity of cognitive impairment. However, research for these severity ranges has cognitive impairment. However, research for these severity ranges has not been established yet.
18-26 = mild cognitive impairment
10-17 = moderate cognitive impairment
less than 10 = severe cognitive impairment
Cognitive Impairment or Alzheimer’s Disease? The cut-off score of 18 is usually considered to separate Cognitive Impairment (CI) from Alzheimer’s Disease The average MoCA score for CI is 22 (range 19-25) and the average MoCA score for Mild AD (11-21) but AD also includes symptoms of a loss of patient’s autonomy.