MoCA Attention and Concentration 3 — Questions and Answers
Question 1: A patient scores 3 points on the MoCA serial 7s subtraction task. How many correct responses did they give?
- 1
- 2
- 3
- 5 (Correct answer)
Correct answer: 5
A score of 3 on serial 7s is only awarded when all 5 subtractions are correct.
Question 2: Which of the following best describes the scoring rule for the MoCA digit span forward task?
- 1 point for any correct response
- 1 point only if the full 5-digit sequence is repeated correctly (Correct answer)
- 2 points if at least 4 digits are correct
- No points — it is unscored
Correct answer: 1 point only if the full 5-digit sequence is repeated correctly
The forward digit span awards 1 point only when the entire 5-digit sequence (21854) is correctly repeated.
Question 3: On the MoCA, the backward digit span uses a sequence of how many digits?
- 3
- 4 (Correct answer)
- 5
- 6
Correct answer: 4
The backward digit span uses a 3-digit sequence (742), and 1 point is awarded for a correct reversal.
Question 4: What is the maximum score a patient can earn on ALL attention and concentration subtests of the MoCA combined?
- 4 points
- 5 points
- 6 points (Correct answer)
- 7 points
Correct answer: 6 points
Attention subtests total 6 points: 1 for digit span forward, 1 for digit span backward, 1 for letter vigilance, and 3 for serial 7s.
Question 5: Why is the serial 7 subtraction task considered a measure of both attention AND executive function on the MoCA?
- It requires reading comprehension
- It demands sustained mental arithmetic while inhibiting previous answers (Correct answer)
- It tests long-term storage of number facts
- It relies on visuospatial processing
Correct answer: It demands sustained mental arithmetic while inhibiting previous answers
Serial subtraction requires holding a running total, inhibiting prior responses, and performing sequential arithmetic — all aspects of executive control.
Question 6: During the MoCA letter vigilance task, the examiner reads a series of letters at a rate of:
- One letter every 2 seconds
- One letter per second (Correct answer)
- Two letters per second
- One letter every 3 seconds
Correct answer: One letter per second
The examiner reads the 30-letter sequence at a pace of one letter per second to standardize the task.
Question 7: Which patient response pattern on the MoCA letter vigilance task indicates perseveration rather than true vigilance impairment?
- Missing most targets
- Tapping on nearly every letter regardless of whether it is an A (Correct answer)
- Tapping only on the first A in the sequence
- Not tapping at all
Correct answer: Tapping on nearly every letter regardless of whether it is an A
Tapping indiscriminately on most letters suggests perseveration or a failure to inhibit responses, rather than simple inattention.
MoCA Attention and Concentration 3
A patient scores 3 points on the MoCA serial 7s subtraction task.
How many correct responses did they give?