MoCA Memory 3 — Questions and Answers
Question 1: Which memory system is primarily assessed by the MoCA delayed recall task?
- Semantic memory
- Procedural memory
- Episodic memory (Correct answer)
- Working memory
Correct answer: Episodic memory
Delayed recall of verbal material over a 5-minute delay primarily measures episodic memory — the ability to encode and consolidate new personal experiences, which is the most vulnerable system in Alzheimer's disease.
Question 2: What is the clinical significance of a patient recalling 0 out of 5 words after the 5-minute delay?
- It is within normal limits for adults over 80
- It is a strong indicator of significant episodic memory impairment (Correct answer)
- It only reflects poor attention during encoding
- It indicates fatigue and should be repeated
Correct answer: It is a strong indicator of significant episodic memory impairment
Recalling 0 words on delayed recall is a strong indicator of significant memory impairment. This is one of the most clinically meaningful findings on the MoCA and warrants further neuropsychological evaluation.
Question 3: How does the MoCA distinguish between an encoding failure and a retrieval failure in the memory section?
- By timing how long each recall takes
- By using category and multiple-choice cues and comparing free vs cued performance (Correct answer)
- By repeating the words three times before the delay
- By administering a separate encoding test
Correct answer: By using category and multiple-choice cues and comparing free vs cued performance
The MoCA uses optional cues (category cues and multiple-choice) for words not freely recalled. If cuing improves recall substantially, this suggests retrieval failure; if cuing does not help, encoding failure is more likely.
Question 4: In Alzheimer's disease, memory performance on the MoCA typically shows:
- Normal free recall but poor cued recall
- Poor free recall that improves significantly with cuing
- Poor free recall that does NOT improve substantially with cuing (Correct answer)
- Normal delayed recall with impaired attention
Correct answer: Poor free recall that does NOT improve substantially with cuing
Alzheimer's disease causes early hippocampal damage and impairs memory consolidation. Patients typically show both poor free recall AND poor cued recall, indicating true encoding failure rather than retrieval difficulty.
Question 5: What is the purpose of administering two immediate recall trials before the delayed recall in the MoCA?
- To score the immediate recall as part of the memory domain
- To maximize initial encoding so delayed recall reflects true retention (Correct answer)
- To tire the patient and make delayed recall more challenging
- Because one trial is not standardized
Correct answer: To maximize initial encoding so delayed recall reflects true retention
Two immediate recall trials maximize the initial encoding of the word list. Without adequate initial learning, a poor delayed recall score could reflect encoding opportunity rather than true retention failure.
Question 6: How many points does the MoCA memory domain contribute to the total score of 30?
- 3 points
- 4 points
- 5 points (Correct answer)
- 6 points
Correct answer: 5 points
The memory domain (delayed recall of five words) contributes 5 points to the total MoCA score of 30, making it the single largest domain on the test.
MoCA Memory 3
Which memory system is primarily assessed by the MoCA delayed recall task?