MoCA Visuospatial Abilities 3 — Questions and Answers
Question 1: The MoCA visuospatial/executive domain contributes how many points to the total score?
- 3 points
- 4 points
- 5 points (Correct answer)
- 6 points
Correct answer: 5 points
The Visuospatial/Executive domain includes: 1 point for Trail Making B, 1 point for cube copy, and 3 points for clock drawing (contour, numbers, hands) = 5 points total.
Question 2: Which neurological condition is particularly associated with severely impaired visuospatial performance on the MoCA?
- Frontotemporal dementia
- Vascular dementia
- Lewy body dementia and posterior cortical atrophy (Correct answer)
- Primary progressive aphasia
Correct answer: Lewy body dementia and posterior cortical atrophy
Lewy body dementia and posterior cortical atrophy (a variant of Alzheimer's disease) are strongly associated with prominent visuospatial deficits, often more severe than memory deficits at early stages.
Question 3: On the MoCA, how is the cube copy task scored?
- 0-3 points based on accuracy
- 0-2 points based on proportion and lines
- 0 or 1 point only (Correct answer)
- 1 point for attempt, 2 for accuracy
Correct answer: 0 or 1 point only
The cube copy is scored as 1 point (correct) or 0 points (incorrect) — a single binary score. There is no partial credit for a partially correct three-dimensional representation.
Question 4: What should the examiner do if a patient asks to see the cube model again during copying?
- Remove the model to test memory for the cube
- Allow the patient to see the model as it remains visible throughout (Correct answer)
- Show the model once more then remove it
- Remind the patient they saw the cube already
Correct answer: Allow the patient to see the model as it remains visible throughout
The stimulus cube remains visible throughout the copying task. It is not taken away from the patient. The patient should be encouraged to refer to the model as needed.
Question 5: A patient with right hemisphere parietal damage would MOST likely show difficulties on which MoCA visuospatial tasks?
- Sentence repetition and letter fluency only
- Cube copy and clock drawing, possibly with left-sided neglect features (Correct answer)
- Serial 7 subtraction and digit span only
- Naming and abstract thinking only
Correct answer: Cube copy and clock drawing, possibly with left-sided neglect features
Right parietal lesions typically produce left-sided spatial neglect and visuoconstructional deficits. This would affect the cube copy and clock drawing (particularly left-sided neglect: numbers clustered on the right, left hand incorrect).
Question 6: When administering the MoCA cube copy task, the examiner should provide the patient with:
- A blank sheet of paper and colored pencils
- The MoCA form with the pre-printed cube model and a pencil (Correct answer)
- A ruler for accurate line drawing
- A three-dimensional block to hold and examine
Correct answer: The MoCA form with the pre-printed cube model and a pencil
The examiner provides the printed MoCA form (which has the cube drawing already on it) and a pen or pencil. No additional tools or grids are given. The patient draws directly on the form.
MoCA Visuospatial Abilities 3
The MoCA visuospatial/executive domain contributes how many points to the total score?