Montreal Cognitive Assessment (MoCA) Scale: Strengths, Limitations, and Implication for Clinical Practice
Abstract
Objective: Mild Cognitive Impairment (MCI) is a transitional state between normal aging and dementia, with high risk of progression. Early detection is essential, and so the Montreal Cognitive Assessment (MoCA) has become a widely used screening tool. Despite its popularity, concerns remain about its psychometric limitations and cultural applicability.
This review aims to critically analyze the MoCA, focusing on the validity and limitations of its subtests, and to propose directions for refinement and clinical adaptation.
Method: We conducted a structured narrative review (2005–2024) using PubMed, Scopus, and Web of Science databases. Search terms included “Montreal Cognitive Assessment”, “MoCA”, “validity”, “psychometrics”, and “cultural adaptation”. Studies evaluating psychometric performance, cultural adaptations, and clinical applications of the MoCA were included. Case reports and studies lacking psychometric evaluation were excluded. An item-by-item critical appraisal was performed.
Results: The MoCA shows superior sensitivity for MCI detection compared to the Mini-Mental State Examination (MMSE), with strengths in brevity, multidomain coverage, and accessibility. However, limitations include: superficial executive function (EF) assessment, cultural and educational bias, lack of recognition/cueing in memory testing, simplistic binary scoring, and risk of floor/ceiling effects. These may affect diagnostic accuracy across populations.
Conclusion: The MoCA remains a valuable tool but should not be used in isolation. Clinicians must consider the cultural/educational context when interpreting results. Refinements such as weighted scoring, cued recall, and culturally adapted items, alongside digital versions, could improve accuracy and fairness. Further empirical validation of these modifications is needed.
1. Anderson ND. State of the science on mild cognitive impairment (MCI). CNS Spectr. 2019;24(1):78-87.
2. Defranceso M, Schocke M, Messner HJ, Deisenhammer EA, Hinterhuber H, Marksteiner J, et al. Conversion from MCI (Mild Cognitive Impairment) to Alzheimer's disease: diagnostic options and predictors. Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater. 2010;24(2):88-98.
3. Özbek Y, Yener G. Event‐related Theta Phase Coherence differ between stable and progressive MCI: aTwo‐Year Follow‐up study. Alzheimer's & Dementia. 2024;20:e090683.
4. Jacob L, Bohlken J, Kostev K. Risk Factors for Mild Cognitive Impairment in German Primary Care Practices. J Alzheimers Dis. 2017;56(1):379-84.
5. Samson AD, Shen K, Grady CL, McIntosh AR. Exploration of salient risk factors involved in mild cognitive impairment. Eur J Neurosci. 2022;56(9):5368-83.
6. Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J. 2012;42(5):484-91.
7. Griffiths J, Thaikruea L, Wongpakaran N, Munkhetvit P. Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics. Dement Geriatr Cogn Dis Extra. 2020;10(1):38-45.
8. Hu C, Wang L, Zhao X, Zhu B, Tian M, Qin H. Investigation of risk factors for the conversion of mild cognitive impairment to dementia. Int J Neurosci. 2021;131(12):1173-80.
9. Sadeghzadeh J, Jafarzadeh J, Hadinezhad P, Nazari A, Sohrabi S, Musazadeh V, et al. Profiling inflammatory mechanisms, hyperphosphorylated tau of hippocampal tissue and spatial memory following vitamin D3 treatment in the mice model of vascular dementia. Int Immunopharmacol. 2023;120:110314.
10. Rahgosha P, Hadinezhad P, Hosseini SH, Abedini E. Working Memory, Rumination, and Autobiographical Memory Specificity Impairment. Iranian Rehabilitation Journal. 2023;21(3):495-502.
11. McGirr A, Nathan S, Ghahremani M, Gill S, Smith EE, Ismail Z. Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late-Onset Neuropsychiatric Symptoms. Neurology. 2022;98(21):e2132-e9.
12. Sachdev PS, Lipnicki DM, Crawford J, Reppermund S, Kochan NA, Trollor JN, et al. Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study. PLoS One. 2013;8(3):e59649.
13. Overton M, Pihlsgård M, Elmståhl S. Diagnostic Stability of Mild Cognitive Impairment, and Predictors of Reversion to Normal Cognitive Functioning. Dement Geriatr Cogn Disord. 2019;48(5-6):317-29.
14. Roberts RO, Knopman DS, Mielke MM, Cha RH, Pankratz VS, Christianson TJ, et al. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology. 2014;82(4):317-25.
15. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors. Dement Geriatr Cogn Disord. 2006;21(1):51-8.
16. Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E, et al. Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology. 2007;68(4):288-91.
17. Farias ST, Mungas D, Reed BR, Harvey D, DeCarli C. Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. Arch Neurol. 2009;66(9):1151-7.
18. Mitchell AJ, Shiri-Feshki M. Temporal trends in the long term risk of progression of mild cognitive impairment: a pooled analysis. J Neurol Neurosurg Psychiatry. 2008;79(12):1386-91.
19. Bruscoli M, Lovestone S. Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr. 2004;16(2):129-40.
20. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9.
21. Chiti G, Pantoni L. Use of Montreal Cognitive Assessment in patients with stroke. Stroke. 2014;45(10):3135-40.
22. Tanveer S, Croucher MJ, Porter R. Cultural modification of neuropsychiatric assessment: complexities to consider. BJPsych Open. 2022;8(2):e68.
23. Jammula V, Rogers JL, Vera E, Christ A, Leeper HE, Acquaye A, et al. The Montreal Cognitive Assessment (MoCA) in neuro-oncology: A pilot study of feasibility and utility in telehealth and in-person clinical assessments. Neurooncol Pract. 2022;9(5):429-40.
24. Islam N, Hashem R, Gad M, Brown A, Levis B, Renoux C, et al. Accuracy of the Montreal Cognitive Assessment tool for detecting mild cognitive impairment: A systematic review and meta-analysis. Alzheimers Dement. 2023;19(7):3235-43.
25. Ang LC, Yap P, Tay SY, Koay WI, Liew TM. Examining the Validity and Utility of Montreal Cognitive Assessment Domain Scores for Early Neurocognitive Disorders. J Am Med Dir Assoc. 2023;24(3):314-20.e2.
26. Moafmashhadi P, Koski L. Limitations for interpreting failure on individual subtests of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol. 2013;26(1):19-28.
27. Ratcliffe LN, McDonald T, Robinson B, Sass JR, Loring DW, Hewitt KC. Classification statistics of the Montreal Cognitive Assessment (MoCA): Are we interpreting the MoCA correctly? Clin Neuropsychol. 2023;37(3):562-76.
28. Davis DH, Creavin ST, Yip JL, Noel-Storr AH, Brayne C, Cullum S. Montreal Cognitive Assessment for the diagnosis of Alzheimer's disease and other dementias. Cochrane Database Syst Rev. 2015;2015(10):Cd010775.
29. Afrashteh F, Almasi-Dooghaee M, Kamyari N, Rajabi R, Baradaran HR. Is Montreal Cognitive Assessment a valuable test for the differentiation of Alzheimer's disease, frontotemporal dementia, dementia with Lewy body, and vascular dementia? Dement Neuropsychol. 2024;18:e20230124.
30. Weissberger GH, Strong JV, Stefanidis KB, Summers MJ, Bondi MW, Stricker NH. Diagnostic Accuracy of Memory Measures in Alzheimer's Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev. 2017;27(4):354-88.
31. Glosser G, Gallo JL, Clark CM, Grossman M. Memory encoding and retrieval in frontotemporal dementia and Alzheimer's disease. Neuropsychology. 2002;16(2):190-6.
32. Gol Mohammad Pour Afrakoti L, Daneshpour Moghadam S, Hadinezhad P. Alzheimer's disease and the immune system: A comprehensive overview with a focus on B cells, humoral immunity, and immunotherapy. J Alzheimers Dis Rep. 2025;9:25424823251329188.
33. Bussè C, Zorzi G, Pettenuzzo I, Mozzetta S, Cagnin A. Episodic Memory in Amnestic Behavioral Frontotemporal Dementia and Alzheimer's Disease. J Alzheimers Dis Rep. 2023;7(1):605-12.
34. Poos JM, Russell LL, Peakman G, Bocchetta M, Greaves CV, Jiskoot LC, et al. Impairment of episodic memory in genetic frontotemporal dementia: A GENFI study. Alzheimers Dement (Amst). 2021;13(1):e12185.
35. Liu CH, Li KY, Liao WW, Chuang IC, Huang YH, Wu CY. Memory benefits of daily-living-related contextual cueing for individuals with subjective cognitive decline and mild cognitive impairment. Hong Kong J Occup Ther. 2024;37(2):111-20.
36. Curiel Cid RE, Matias-Guiu JA, Loewenstein DA. A review of novel Cognitive Challenge Tests for the assessment of preclinical Alzheimer's disease. Neuropsychology. 2023;37(6):661-72.
37. Kirkbride E, Ferreira-Correia A, Sibandze M. Montreal Cognitive Assessment: Exploring the impact of demographic variables, internal consistency reliability and discriminant validity in a South African sample. Afr J Psychol Assess.2022;4:9.
38. Stimmel MB, Orkaby AR, Ayers E, Verghese J, Nsubayi CK, Weiss EF. Is the Montreal cognitive assessment culturally valid in a diverse geriatric primary care setting? Lessons from the Bronx. J Am Geriatr Soc. 2024;72(3):850-7.
39. Wei Q, Du B, Liu Y, Cao S, Yin S, Zhang Y, et al. The Montreal cognitive assessment: normative data from a large, population-based sample of Chinese healthy adults and validation for detecting vascular cognitive impairment. Front Neurosci. 2024;18:1455129.
40. Smith T, Gildeh N, Holmes C. The Montreal Cognitive Assessment: validity and utility in a memory clinic setting. Can J Psychiatry. 2007;52(5):329-32.
41. Beath N, Asmal L, van den Heuvel L, Seedat S. Validation of the Montreal cognitive assessment against the RBANS in a healthy South African cohort. S Afr J Psychiatr. 2018;24:1304.
42. O'Driscoll C, Shaikh M. Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review. J Alzheimers Dis. 2017;58(3):789-801.
43. Naole S, Parikh D, Nayak S, Ramu SP. Evaluating Cognitive Assessment Tools: A Comparative Analysis of MMSE, RUDAS, SAGE, ADAS and MoCA for Early Dementia Detection. arXiv preprint arXiv:250507246. 2025.
44. Dautzenberg G, Lijmer J, Beekman A. Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age psychiatry: Determining cutoff scores in clinical practice. Avoiding spectrum bias caused by healthy controls. Int J Geriatr Psychiatry. 2020;35(3):261-9.
45. Hendershott TR, Zhu D, Llanes S, Poston KL. Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson's disease. Parkinsonism Relat Disord. 2017;38:31-4.
46. Malek-Ahmadi M, Nikkhahmanesh N. Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment. Front Psychol. 2024;15:1369766.
47. Daniel B, Agenagnew L, Workicho A, Abera M. Psychometric Properties of the Montreal Cognitive Assessment (MoCA) to Detect Major Neurocognitive Disorder Among Older People in Ethiopia: A Validation Study. Neuropsychiatr Dis Treat. 2022;18:1789-98.
48. Khan G, Mirza N, Waheed W. Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis. BJPsych Open. 2022;8(1):e21.
49. Theocharous S, Savage G, Charalambous AP, Côté M, David R, Gallant K, et al. A cross-cultural study of the Montreal Cognitive Assessment for people with hearing impairment. J Am Geriatr Soc. 2024;72(10):3156-62.
50. Nasreddine ZS. MoCA Test Mandatory Training and Certification: What Is the Purpose? J Am Geriatr Soc. 2020;68(2):444-5.
51. Dominguez JC, Orquiza MG, Soriano JR, Magpantay CD, Esteban RC, Corrales ML, et al. Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients. East Asian Arch Psychiatry. 2013;23(3):80-5.
52. de Leon J, Bondoc I, Mamuyac E, Posecion L, Europa E, Kintanar LC, et al. The development of the Cognitive Assessment for Tagalog Speakers (CATS): A culturally and linguistically tailored test battery for Filipino Americans. Alzheimers Dement (N Y). 2023;9(3):e12418.
53. Coelho JCF, Ribeiro ARM, Sampaio FMC, Sequeira C, Lleixà Fortuño MDM, Roldán Merino J. Cultural Adaptation and Psychometric Properties Assessment of the NOC Outcome "Cognition" in a Sample of Portuguese Adults With Mental Illness. Int J Nurs Knowl. 2020;31(3):180-7.
54. Yangyuensathaporn B, Chansaengpetch S, Jongsawadipatana A, Muangpaisan W. Validation of an Application-Based Cognitive Screening Test for Older Thai Adults. Dement Geriatr Cogn Disord. 2025;54(4):214-25.
55. Hemrungrojn S, Amrapala A, Kasemsantitham AA, Dithanat P, Lapanan K, Chaiyasurayakan K, et al. The Validity of the Thai Electronic Version of the Montreal Cognitive Assessment (MoCA). Alzheimer's & Dementia. 2023;19:e079254.
56. Hemrungrojn S, Tangwongchai S, Charoenboon T, Panasawat M, Supasitthumrong T, Chaipresertsud P, et al. Use of the Montreal Cognitive Assessment Thai Version to Discriminate Amnestic Mild Cognitive Impairment from Alzheimer's Disease and Healthy Controls: Machine Learning Results. Dement Geriatr Cogn Disord. 2021;50(2):183-94.
2. Defranceso M, Schocke M, Messner HJ, Deisenhammer EA, Hinterhuber H, Marksteiner J, et al. Conversion from MCI (Mild Cognitive Impairment) to Alzheimer's disease: diagnostic options and predictors. Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater. 2010;24(2):88-98.
3. Özbek Y, Yener G. Event‐related Theta Phase Coherence differ between stable and progressive MCI: aTwo‐Year Follow‐up study. Alzheimer's & Dementia. 2024;20:e090683.
4. Jacob L, Bohlken J, Kostev K. Risk Factors for Mild Cognitive Impairment in German Primary Care Practices. J Alzheimers Dis. 2017;56(1):379-84.
5. Samson AD, Shen K, Grady CL, McIntosh AR. Exploration of salient risk factors involved in mild cognitive impairment. Eur J Neurosci. 2022;56(9):5368-83.
6. Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J. 2012;42(5):484-91.
7. Griffiths J, Thaikruea L, Wongpakaran N, Munkhetvit P. Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics. Dement Geriatr Cogn Dis Extra. 2020;10(1):38-45.
8. Hu C, Wang L, Zhao X, Zhu B, Tian M, Qin H. Investigation of risk factors for the conversion of mild cognitive impairment to dementia. Int J Neurosci. 2021;131(12):1173-80.
9. Sadeghzadeh J, Jafarzadeh J, Hadinezhad P, Nazari A, Sohrabi S, Musazadeh V, et al. Profiling inflammatory mechanisms, hyperphosphorylated tau of hippocampal tissue and spatial memory following vitamin D3 treatment in the mice model of vascular dementia. Int Immunopharmacol. 2023;120:110314.
10. Rahgosha P, Hadinezhad P, Hosseini SH, Abedini E. Working Memory, Rumination, and Autobiographical Memory Specificity Impairment. Iranian Rehabilitation Journal. 2023;21(3):495-502.
11. McGirr A, Nathan S, Ghahremani M, Gill S, Smith EE, Ismail Z. Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late-Onset Neuropsychiatric Symptoms. Neurology. 2022;98(21):e2132-e9.
12. Sachdev PS, Lipnicki DM, Crawford J, Reppermund S, Kochan NA, Trollor JN, et al. Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study. PLoS One. 2013;8(3):e59649.
13. Overton M, Pihlsgård M, Elmståhl S. Diagnostic Stability of Mild Cognitive Impairment, and Predictors of Reversion to Normal Cognitive Functioning. Dement Geriatr Cogn Disord. 2019;48(5-6):317-29.
14. Roberts RO, Knopman DS, Mielke MM, Cha RH, Pankratz VS, Christianson TJ, et al. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology. 2014;82(4):317-25.
15. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors. Dement Geriatr Cogn Disord. 2006;21(1):51-8.
16. Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E, et al. Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology. 2007;68(4):288-91.
17. Farias ST, Mungas D, Reed BR, Harvey D, DeCarli C. Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts. Arch Neurol. 2009;66(9):1151-7.
18. Mitchell AJ, Shiri-Feshki M. Temporal trends in the long term risk of progression of mild cognitive impairment: a pooled analysis. J Neurol Neurosurg Psychiatry. 2008;79(12):1386-91.
19. Bruscoli M, Lovestone S. Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr. 2004;16(2):129-40.
20. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9.
21. Chiti G, Pantoni L. Use of Montreal Cognitive Assessment in patients with stroke. Stroke. 2014;45(10):3135-40.
22. Tanveer S, Croucher MJ, Porter R. Cultural modification of neuropsychiatric assessment: complexities to consider. BJPsych Open. 2022;8(2):e68.
23. Jammula V, Rogers JL, Vera E, Christ A, Leeper HE, Acquaye A, et al. The Montreal Cognitive Assessment (MoCA) in neuro-oncology: A pilot study of feasibility and utility in telehealth and in-person clinical assessments. Neurooncol Pract. 2022;9(5):429-40.
24. Islam N, Hashem R, Gad M, Brown A, Levis B, Renoux C, et al. Accuracy of the Montreal Cognitive Assessment tool for detecting mild cognitive impairment: A systematic review and meta-analysis. Alzheimers Dement. 2023;19(7):3235-43.
25. Ang LC, Yap P, Tay SY, Koay WI, Liew TM. Examining the Validity and Utility of Montreal Cognitive Assessment Domain Scores for Early Neurocognitive Disorders. J Am Med Dir Assoc. 2023;24(3):314-20.e2.
26. Moafmashhadi P, Koski L. Limitations for interpreting failure on individual subtests of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol. 2013;26(1):19-28.
27. Ratcliffe LN, McDonald T, Robinson B, Sass JR, Loring DW, Hewitt KC. Classification statistics of the Montreal Cognitive Assessment (MoCA): Are we interpreting the MoCA correctly? Clin Neuropsychol. 2023;37(3):562-76.
28. Davis DH, Creavin ST, Yip JL, Noel-Storr AH, Brayne C, Cullum S. Montreal Cognitive Assessment for the diagnosis of Alzheimer's disease and other dementias. Cochrane Database Syst Rev. 2015;2015(10):Cd010775.
29. Afrashteh F, Almasi-Dooghaee M, Kamyari N, Rajabi R, Baradaran HR. Is Montreal Cognitive Assessment a valuable test for the differentiation of Alzheimer's disease, frontotemporal dementia, dementia with Lewy body, and vascular dementia? Dement Neuropsychol. 2024;18:e20230124.
30. Weissberger GH, Strong JV, Stefanidis KB, Summers MJ, Bondi MW, Stricker NH. Diagnostic Accuracy of Memory Measures in Alzheimer's Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev. 2017;27(4):354-88.
31. Glosser G, Gallo JL, Clark CM, Grossman M. Memory encoding and retrieval in frontotemporal dementia and Alzheimer's disease. Neuropsychology. 2002;16(2):190-6.
32. Gol Mohammad Pour Afrakoti L, Daneshpour Moghadam S, Hadinezhad P. Alzheimer's disease and the immune system: A comprehensive overview with a focus on B cells, humoral immunity, and immunotherapy. J Alzheimers Dis Rep. 2025;9:25424823251329188.
33. Bussè C, Zorzi G, Pettenuzzo I, Mozzetta S, Cagnin A. Episodic Memory in Amnestic Behavioral Frontotemporal Dementia and Alzheimer's Disease. J Alzheimers Dis Rep. 2023;7(1):605-12.
34. Poos JM, Russell LL, Peakman G, Bocchetta M, Greaves CV, Jiskoot LC, et al. Impairment of episodic memory in genetic frontotemporal dementia: A GENFI study. Alzheimers Dement (Amst). 2021;13(1):e12185.
35. Liu CH, Li KY, Liao WW, Chuang IC, Huang YH, Wu CY. Memory benefits of daily-living-related contextual cueing for individuals with subjective cognitive decline and mild cognitive impairment. Hong Kong J Occup Ther. 2024;37(2):111-20.
36. Curiel Cid RE, Matias-Guiu JA, Loewenstein DA. A review of novel Cognitive Challenge Tests for the assessment of preclinical Alzheimer's disease. Neuropsychology. 2023;37(6):661-72.
37. Kirkbride E, Ferreira-Correia A, Sibandze M. Montreal Cognitive Assessment: Exploring the impact of demographic variables, internal consistency reliability and discriminant validity in a South African sample. Afr J Psychol Assess.2022;4:9.
38. Stimmel MB, Orkaby AR, Ayers E, Verghese J, Nsubayi CK, Weiss EF. Is the Montreal cognitive assessment culturally valid in a diverse geriatric primary care setting? Lessons from the Bronx. J Am Geriatr Soc. 2024;72(3):850-7.
39. Wei Q, Du B, Liu Y, Cao S, Yin S, Zhang Y, et al. The Montreal cognitive assessment: normative data from a large, population-based sample of Chinese healthy adults and validation for detecting vascular cognitive impairment. Front Neurosci. 2024;18:1455129.
40. Smith T, Gildeh N, Holmes C. The Montreal Cognitive Assessment: validity and utility in a memory clinic setting. Can J Psychiatry. 2007;52(5):329-32.
41. Beath N, Asmal L, van den Heuvel L, Seedat S. Validation of the Montreal cognitive assessment against the RBANS in a healthy South African cohort. S Afr J Psychiatr. 2018;24:1304.
42. O'Driscoll C, Shaikh M. Cross-Cultural Applicability of the Montreal Cognitive Assessment (MoCA): A Systematic Review. J Alzheimers Dis. 2017;58(3):789-801.
43. Naole S, Parikh D, Nayak S, Ramu SP. Evaluating Cognitive Assessment Tools: A Comparative Analysis of MMSE, RUDAS, SAGE, ADAS and MoCA for Early Dementia Detection. arXiv preprint arXiv:250507246. 2025.
44. Dautzenberg G, Lijmer J, Beekman A. Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age psychiatry: Determining cutoff scores in clinical practice. Avoiding spectrum bias caused by healthy controls. Int J Geriatr Psychiatry. 2020;35(3):261-9.
45. Hendershott TR, Zhu D, Llanes S, Poston KL. Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson's disease. Parkinsonism Relat Disord. 2017;38:31-4.
46. Malek-Ahmadi M, Nikkhahmanesh N. Meta-analysis of Montreal cognitive assessment diagnostic accuracy in amnestic mild cognitive impairment. Front Psychol. 2024;15:1369766.
47. Daniel B, Agenagnew L, Workicho A, Abera M. Psychometric Properties of the Montreal Cognitive Assessment (MoCA) to Detect Major Neurocognitive Disorder Among Older People in Ethiopia: A Validation Study. Neuropsychiatr Dis Treat. 2022;18:1789-98.
48. Khan G, Mirza N, Waheed W. Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis. BJPsych Open. 2022;8(1):e21.
49. Theocharous S, Savage G, Charalambous AP, Côté M, David R, Gallant K, et al. A cross-cultural study of the Montreal Cognitive Assessment for people with hearing impairment. J Am Geriatr Soc. 2024;72(10):3156-62.
50. Nasreddine ZS. MoCA Test Mandatory Training and Certification: What Is the Purpose? J Am Geriatr Soc. 2020;68(2):444-5.
51. Dominguez JC, Orquiza MG, Soriano JR, Magpantay CD, Esteban RC, Corrales ML, et al. Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients. East Asian Arch Psychiatry. 2013;23(3):80-5.
52. de Leon J, Bondoc I, Mamuyac E, Posecion L, Europa E, Kintanar LC, et al. The development of the Cognitive Assessment for Tagalog Speakers (CATS): A culturally and linguistically tailored test battery for Filipino Americans. Alzheimers Dement (N Y). 2023;9(3):e12418.
53. Coelho JCF, Ribeiro ARM, Sampaio FMC, Sequeira C, Lleixà Fortuño MDM, Roldán Merino J. Cultural Adaptation and Psychometric Properties Assessment of the NOC Outcome "Cognition" in a Sample of Portuguese Adults With Mental Illness. Int J Nurs Knowl. 2020;31(3):180-7.
54. Yangyuensathaporn B, Chansaengpetch S, Jongsawadipatana A, Muangpaisan W. Validation of an Application-Based Cognitive Screening Test for Older Thai Adults. Dement Geriatr Cogn Disord. 2025;54(4):214-25.
55. Hemrungrojn S, Amrapala A, Kasemsantitham AA, Dithanat P, Lapanan K, Chaiyasurayakan K, et al. The Validity of the Thai Electronic Version of the Montreal Cognitive Assessment (MoCA). Alzheimer's & Dementia. 2023;19:e079254.
56. Hemrungrojn S, Tangwongchai S, Charoenboon T, Panasawat M, Supasitthumrong T, Chaipresertsud P, et al. Use of the Montreal Cognitive Assessment Thai Version to Discriminate Amnestic Mild Cognitive Impairment from Alzheimer's Disease and Healthy Controls: Machine Learning Results. Dement Geriatr Cogn Disord. 2021;50(2):183-94.
| Files | ||
| Issue | Articles in Press | |
| Section | Review Article(s) | |
| Keywords | ||
| Alzheimer Disease Dementia Mild Cognitive Impairment Montreal Cognitive Assessment (MoCA) | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Hadinezhad P, Noroozian M. Montreal Cognitive Assessment (MoCA) Scale: Strengths, Limitations, and Implication for Clinical Practice. Iran J Psychiatry. 2025;:1-11.
