MoCA Clock Drawing 2 — Questions and Answers
Question 1: What time is the patient asked to draw on the clock during the MoCA?
- 3 o'clock
- 10 past 11 (Correct answer)
- 6 o'clock
- 12 o'clock
Correct answer: 10 past 11
The standard MoCA clock drawing instruction asks the patient to draw 10 past 11 (11:10). This specific time is used to test placement of hands in an asymmetric position that reveals executive planning difficulties.
Question 2: In the MoCA clock drawing task, how many points are available and what do they assess?
- 2 points: circle and numbers
- 3 points: contour, number placement, and hand placement (Correct answer)
- 4 points: circle, numbers, hands, and proportion
- 5 points: all clock features
Correct answer: 3 points: contour, number placement, and hand placement
The clock drawing task is worth 3 points: 1 for a correctly drawn contour (circle), 1 for correct number placement, and 1 for correct hand placement.
Question 3: A clock that has all 12 numbers present but they are crowded on one side of the circle should be scored as:
- Full points because all numbers are present
- 0 for number placement because spacing is incorrect (Correct answer)
- Full points because the patient tried
- 1 point for numbers if 10 or more are present
Correct answer: 0 for number placement because spacing is incorrect
Numbers that are significantly misplaced, bunched to one side, or not approximately evenly spaced fail the number placement criterion, scoring 0 for that sub-point.
Question 4: Which cognitive abilities does the MoCA clock drawing task primarily assess?
- Language and memory
- Orientation and attention
- Visuospatial ability, constructional praxis, and executive planning (Correct answer)
- Calculation and abstraction
Correct answer: Visuospatial ability, constructional praxis, and executive planning
Clock drawing tests visuospatial ability (contour and number layout), visuoconstructional skill, and executive functioning (planning the placement of hands to a specified time).
Question 5: For clock hands to earn the MoCA hand placement point, they must:
- Be the same length and point in approximately the right direction
- Indicate 10 past 11 with the minute hand longer than the hour hand (Correct answer)
- Simply touch the correct numbers
- Be drawn without any gap between them
Correct answer: Indicate 10 past 11 with the minute hand longer than the hour hand
The hands must clearly indicate 10 past 11 (hour hand near 11, minute hand near 2) and the minute hand should be noticeably longer than the hour hand to earn the full point.
Question 6: Why does the MoCA use clock drawing rather than simply asking the patient to state the time?
- Because many elderly patients cannot read
- Because it tests more cognitive domains including visuospatial and executive planning (Correct answer)
- Because verbal time-telling is too easy for all patients
- Because drawing measures motor skills only
Correct answer: Because it tests more cognitive domains including visuospatial and executive planning
Drawing requires active construction and planning — it engages visuospatial and executive systems that verbal time-telling does not. Patients with executive or visuospatial deficits often fail to draw clocks correctly even when they can verbally state the correct time.
MoCA Clock Drawing 2
What time is the patient asked to draw on the clock during the MoCA?