MoCA Word Recall 3 — Questions and Answers
Question 1: Why does the MoCA use five words rather than a shorter or longer list?
- Because 5 is the maximum working memory capacity
- Because 5 provides optimal sensitivity to mild encoding deficits within a brief testing format (Correct answer)
- Because longer lists are not validated
- Because 5 words fits exactly in a single breath
Correct answer: Because 5 provides optimal sensitivity to mild encoding deficits within a brief testing format
Five words provides a list length that is sensitive to mild encoding deficits (too short a list is too easy; too long would overwhelm attention). It mirrors standard clinical word list tests while keeping administration brief.
Question 2: The MoCA word recall section most specifically taxes which memory system?
- Procedural memory
- Semantic memory
- Episodic memory (Correct answer)
- Working memory
Correct answer: Episodic memory
Encoding five unrelated words across two trials and recalling them after a 5-minute delay primarily taxes episodic memory — the system for new learning and recall of personally experienced events.
Question 3: During the second immediate recall trial of the MoCA word list, the examiner should:
- Tell the patient which words they forgot in trial 1
- Ask the patient to recall the words again without any feedback (Correct answer)
- Show the patient the written word list for 10 seconds
- Read only the words the patient missed in trial 1
Correct answer: Ask the patient to recall the words again without any feedback
The examiner simply asks the patient to recall the words again. No feedback is given about whether words from the first trial were correct. The examiner records what is said but does not score either trial.
Question 4: How does the MoCA word recall task distinguish patients with MCI from those with normal cognition?
- MCI patients recall more words due to anxiety-driven attention
- MCI patients recall the same words but faster
- MCI patients show fewer words recalled and more forgetting over the 5-minute delay (Correct answer)
- MCI patients perform identically to normal controls on word recall
Correct answer: MCI patients show fewer words recalled and more forgetting over the 5-minute delay
Patients with MCI, particularly amnestic MCI, typically recall fewer words immediately and show greater forgetting over the 5-minute delay compared to cognitively normal peers, making delayed recall the most discriminating marker.
Question 5: On the MoCA, what instruction is given to the patient before the word list is read for the first time?
- "Listen carefully and try to memorize these words for a test in 30 minutes"
- "I am going to read a list of words — remember as many as you can now and later on" (Correct answer)
- "You do not need to remember these words, just listen"
- "Repeat each word after I say it"
Correct answer: "I am going to read a list of words — remember as many as you can now and later on"
The patient is told: "This is a memory test. I am going to read a list of words that you will have to remember now and later on." This pre-task instruction ensures the patient knows to attend to and retain the words.
Question 6: The word DAISY in the MoCA word list belongs to which semantic category, and why is that category included?
- It is a color, to match RED for category balance
- It is a flower — included to represent the living things/plant semantic category (Correct answer)
- It is a person's name, representing the person category
- It is an abstract concept, representing the abstract semantic category
Correct answer: It is a flower — included to represent the living things/plant semantic category
DAISY is a flower. Five distinct categories (person feature, texture/fabric, building, flower, color) are used to ensure the words span different semantic fields, preventing inter-item semantic associations that could assist recall.
MoCA Word Recall 3
Why does the MoCA use five words rather than a shorter or longer list?