MoCA Executive Functioning 3

Question 1

If a patient on the Trail Making B task connects 1-A-2-B-3-D (skipping C) but then self-corrects, how is this scored?

Accepted Answer

1 point — prompt self-correction is acceptable

Answer

On the MoCA, the examiner is instructed to point out errors immediately and allow the patient to self-correct without penalty, as long as the correction is made promptly. A successful self-correction does not automatically fail the trial.

Question 2

Which MoCA tasks fall under the Visuospatial/Executive domain?

Accepted Answer

Trail Making B, cube copy, and clock drawing

Answer

The Visuospatial/Executive domain includes the Trail Making B task, the cube copy task, and the clock drawing task — all requiring spatial organization and/or executive planning.

Question 3

What does impaired performance on the MoCA executive tasks (Trail Making B, fluency) indicate clinically?

Accepted Answer

Prefrontal-subcortical circuit dysfunction, seen in vascular or Parkinson's-related dementia

Answer

Poor executive functioning on the MoCA suggests dysfunction of prefrontal-subcortical circuits. This is common in vascular dementia, Parkinson's disease, and frontal lobe disorders.

Question 4

A patient earns 0 on Trail Making B, 0 on clock drawing, and 0 on letter fluency. What does this pattern suggest?

Accepted Answer

Broad executive dysfunction across multiple components

Answer

Failure across all three executive domain tasks (Trail Making B, clock, fluency) indicates a broad executive impairment affecting cognitive flexibility, planning, and generative thinking.

Question 5

In the MoCA cube copy task, what does the examiner ask the patient to do?

Accepted Answer

Copy the provided three-dimensional cube drawing

Answer

The patient is asked to copy a line drawing of a three-dimensional cube. The copy must be three-dimensional and the lines roughly parallel and equal in length to earn 1 point.

(MoCA) Montreal Cognitive Assessment Practice Test

(MoCA) Montreal Cognitive Assessment Practice Test

MoCA Executive Functioning 3