MoCA Abstraction and Language — Questions and Answers
Question 1: Which word pair is used as the unscored practice example in the MoCA abstraction task?
- Train and bicycle
- Watch and ruler
- Banana and orange (Correct answer)
- Apple and pear
Correct answer: Banana and orange
Banana and orange is the practice item, with the answer 'fruit'.
The MoCA abstraction task begins with an example: the examiner asks how a banana and an orange are alike. If the patient gives a concrete answer, the examiner supplies the abstract answer 'they are both fruit'. This practice pair is not scored; it exists to make sure the patient understands the task before the two scored pairs.
Question 2: Which two word pairs are scored in the MoCA abstraction section?
- Banana-orange and train-bicycle
- Train-bicycle and watch-ruler (Correct answer)
- Watch-ruler and lion-camel
- Church-daisy and face-velvet
Correct answer: Train-bicycle and watch-ruler
The scored pairs are train-bicycle and watch-ruler.
After the practice pair, the examiner asks how a train and a bicycle are alike, and then how a watch and a ruler are alike. Each pair is worth one point, for a total of two. The task assesses the ability to identify abstract, category-level similarities rather than superficial or concrete features.
Question 3: A patient says a train and a bicycle are alike because 'they both have wheels'. How is this scored on the MoCA?
- 1 point, because it is a true statement
- 1 point, but only if the patient also mentions travel
- 0 points, because it is a concrete rather than abstract similarity (Correct answer)
- 0.5 points for a partially correct answer
Correct answer: 0 points, because it is a concrete rather than abstract similarity
'Both have wheels' is concrete and does not earn the point.
The MoCA accepts abstract answers such as 'means of transportation', 'means of travelling', or 'you take trips in both' for the train-bicycle pair. Answers describing physical features, such as 'they have wheels', are concrete and receive no credit. The examiner does not prompt further on the scored pairs after the initial question.
Question 4: Which response would earn the point for the watch-ruler pair on the MoCA?
- 'Both have numbers on them'
- 'Both are measuring instruments' (Correct answer)
- 'Both are made of metal'
- 'You can hold both in your hand'
Correct answer: 'Both are measuring instruments'
'Measuring instruments' or 'used to measure' is the accepted abstract answer.
For watch and ruler, acceptable answers include 'measuring instruments' or 'used to measure'. Responses about numbers, materials, or size are concrete and score zero. The examiner records the exact response, which can help later in interpreting executive function.
Question 5: How many sentences must the patient repeat in the MoCA sentence repetition task, and how many points is each worth?
- One sentence worth 2 points
- Two sentences worth 1 point each (Correct answer)
- Three sentences worth 1 point each
- Two sentences worth 2 points each
Correct answer: Two sentences worth 1 point each
Two sentences are repeated, each worth one point.
The examiner reads two sentences one at a time, and the patient must repeat each one exactly. The first is 'I only know that John is the one to help today', and the second is 'The cat always hid under the couch when dogs were in the room'. One point is given per sentence, for a maximum of two.
Question 6: A patient repeats 'The cat always hid under the couch when the dogs were in the room' (adding 'the' before 'dogs'). How is this scored?
- 1 point, since the meaning is unchanged
- 1 point, since only one word was added
- 0 points, because the repetition must be exact (Correct answer)
- 0 points, but the examiner repeats the sentence for a second attempt
Correct answer: 0 points, because the repetition must be exact
Any omission, substitution, or addition scores zero; repetition must be verbatim.
MoCA sentence repetition is scored for exact reproduction. Adding, omitting, or substituting even a small word such as 'the' results in no point for that sentence. The examiner reads each sentence only once and does not offer a second attempt, so patients should be encouraged to listen carefully before responding.
MoCA Abstraction and Language
Which word pair is used as the unscored practice example in the MoCA abstraction task?