MoCA Delayed Recall 3 — Questions and Answers
Question 1: Which of the following best describes why optional cues in MoCA delayed recall do NOT earn full points?
- Because cues are too easy
- Because they distinguish encoding failure from retrieval failure (Correct answer)
- Because cues indicate cheating
- Because cued responses inflate the total score artificially
Correct answer: Because they distinguish encoding failure from retrieval failure
The distinction between free recall and cued recall is clinically important. Cuing a word that could not be freely recalled suggests retrieval difficulty rather than encoding failure, a different pattern of impairment.
Question 2: A patient recalls 3 of 5 words freely and retrieves 1 more word with a category cue. The standard MoCA delayed recall score is:
- 4 points
- 3 points (Correct answer)
- 2 points
- 3.5 points
Correct answer: 3 points
Standard MoCA scoring for the 5-point delayed recall domain counts only freely recalled words. Three freely recalled words = 3 points. The word retrieved via cue does not add to the 5-point total.
Question 3: The words used in the MoCA delayed recall section are typically drawn from which categories?
- Numbers and letters
- Abstract concepts and actions
- A person, a fabric, a building, a flower, and a color (Correct answer)
- Animals, foods, and occupations
Correct answer: A person, a fabric, a building, a flower, and a color
The standard MoCA v7.1 delayed recall words are: FACE, VELVET, CHURCH, DAISY, RED — spanning person, fabric, building, flower, and color categories to represent diverse semantic categories.
Question 4: Which type of dementia most characteristically shows impaired free recall with improved performance on multiple-choice cuing?
- Alzheimer's disease
- Subcortical dementias (e.g., vascular, Lewy body) (Correct answer)
- Frontotemporal dementia
- Creutzfeldt-Jakob disease
Correct answer: Subcortical dementias (e.g., vascular, Lewy body)
In subcortical dementias (e.g., vascular, Lewy body, Parkinson-related), the primary deficit is retrieval. Providing choices often significantly improves performance, distinguishing these from Alzheimer's where encoding itself is impaired.
Question 5: During the MoCA, when is the delayed recall task administered?
- Immediately after the word encoding trial
- After 30 minutes of a separate distractor task
- At the end of the MoCA, after all other tasks are completed (Correct answer)
- At the start, before other tasks
Correct answer: At the end of the MoCA, after all other tasks are completed
The delayed recall task is administered at the END of the MoCA, after the other domains have been tested. This ensures the delay time (approximately 5 minutes) has elapsed from the initial word presentation.
Question 6: A clinician notes a patient recalled 0 words freely but correctly identified all 5 words on multiple-choice. This most suggests:
- Severe global amnesia
- A retrieval deficit rather than a storage/encoding deficit (Correct answer)
- Malingering or poor effort
- Normal aging only
Correct answer: A retrieval deficit rather than a storage/encoding deficit
Intact recognition with failed free recall suggests a retrieval failure rather than storage/encoding failure, a pattern more consistent with subcortical or frontal pathology than Alzheimer's disease.
MoCA Delayed Recall 3
Which of the following best describes why optional cues in MoCA delayed recall do NOT earn full points?