MoCA Clock Drawing 3 — Questions and Answers
Question 1: On the MoCA, a patient draws a square instead of a circle for the clock contour. The contour criterion is scored:
- 1 point — any closed shape is acceptable
- 0 points — the contour must be a circle (Correct answer)
- 0.5 points — partial credit for a closed shape
- 1 point if the shape is symmetrical
Correct answer: 0 points — the contour must be a circle
The clock contour must be a recognizable circle. A clearly non-circular shape (square, rectangle) does not meet the criterion for the contour point, scoring 0 for that sub-point.
Question 2: In MoCA clock drawing, the number placement point is awarded when:
- At least 6 numbers are present anywhere inside the circle
- All 12 numbers are present in correct sequential clockwise position with reasonable spacing (Correct answer)
- The numbers 12, 3, 6, and 9 are correctly placed
- Numbers are placed outside the circle but in sequence
Correct answer: All 12 numbers are present in correct sequential clockwise position with reasonable spacing
To earn the number placement point, all 12 numbers must be present, and they must be arranged in a roughly correct clockwise sequence with appropriate spacing.
Question 3: A patient draws a perfect clock circle and places all numbers correctly but forgets to add the hands. The clock drawing score is:
- 0 points — hands are required
- 1 point
- 2 points (Correct answer)
- 3 points
Correct answer: 2 points
Without hands, only the contour (1 pt) and number placement (1 pt) criteria can be met. The hand placement point (1 pt) cannot be awarded, yielding a maximum of 2 out of 3.
Question 4: When a patient with moderate tremor draws a slightly irregular clock circle, the examiner should:
- Score 0 for contour automatically
- Disqualify the clock drawing task
- Award the contour point if it is recognizably a circle despite tremor (Correct answer)
- Ask the patient to redraw more carefully
Correct answer: Award the contour point if it is recognizably a circle despite tremor
Mild tremor or motor impairment that does not obscure the intent of the drawing is not penalized. The examiner should judge whether the overall intention is correct, not the neatness of execution.
Question 5: The MoCA clock drawing task belongs to which cognitive domain on the assessment form?
- Memory
- Language
- Visuospatial/Executive (Correct answer)
- Orientation
Correct answer: Visuospatial/Executive
Clock drawing is placed within the Visuospatial/Executive domain on the MoCA form because it tests both spatial construction and executive planning simultaneously.
Question 6: Why is 10 past 11 specifically chosen as the time for MoCA clock drawing?
- It is the easiest time to draw
- Because it is a round number
- It creates an asymmetric hand placement that reveals planning errors (Correct answer)
- Because it avoids the 6 o'clock position
Correct answer: It creates an asymmetric hand placement that reveals planning errors
10 past 11 is selected because it places hands in asymmetric positions (one near 11, one near 2). It avoids a common error where patients focus hands on the "ten" in "ten past" and point both hands near 10, revealing executive planning difficulties.
MoCA Clock Drawing 3
On the MoCA, a patient draws a square instead of a circle for the clock contour.
The contour criterion is scored: