MoCA Memory Recall 2 — Questions and Answers
Question 1: What is the category cue the examiner gives for the word 'Church' if it is not freely recalled on the MoCA?
- A type of building (Correct answer)
- A colour
- A part of the body
- A type of fabric
Correct answer: A type of building
'Church' is cued with the category 'a type of building'.
The MoCA provides specific category cues for each word: 'Face' is a part of the body, 'Velvet' is a type of fabric, 'Church' is a type of building, 'Daisy' is a type of flower, and 'Red' is a colour. The category cue is given only for words the patient failed to recall spontaneously, and it is used after free recall is completed.
Question 2: If a patient still cannot retrieve a word after the category cue, what is the next step in MoCA delayed recall?
- The examiner tells the patient the word and moves on
- The examiner gives a multiple-choice cue with the target and two distractors (Correct answer)
- The examiner re-reads the entire word list
- The examiner ends the memory section immediately
Correct answer: The examiner gives a multiple-choice cue with the target and two distractors
A multiple-choice cue follows the category cue for any word still not recalled.
MoCA delayed recall has three levels: free recall, category cue, and multiple-choice recognition. For a word missed after the category cue, the examiner offers three choices, for example 'nose, face, hand' for the word 'Face'. The multiple-choice response is recorded but, like the category cue, does not earn points toward the total score.
Question 3: Why does the MoCA record cued recall performance even though it is not scored?
- To calculate the time taken for the test
- To distinguish a retrieval problem from an encoding or storage problem (Correct answer)
- To decide whether to add the education bonus point
- To determine the patient's dominant hand
Correct answer: To distinguish a retrieval problem from an encoding or storage problem
Cued recall helps clinicians tell retrieval failure apart from a true storage deficit.
Patients who recall words once cued are more likely to have a retrieval difficulty, which is often seen in frontal-subcortical or attentional problems. Patients who fail even with multiple-choice recognition are more likely to have impaired encoding or storage, a pattern typical of amnestic conditions such as Alzheimer's disease. This is why the examiner notes cued performance despite it not affecting the score.
Question 4: What is the maximum value of the MoCA Memory Index Score (MIS)?
- 5
- 10
- 15 (Correct answer)
- 30
Correct answer: 15
The Memory Index Score ranges from 0 to 15.
The Memory Index Score is calculated by multiplying the number of words freely recalled by 3, the number recalled with a category cue by 2, and the number recognized with multiple choice by 1, then summing. With five words, the maximum is 5 x 3 = 15. The MIS gives a more graded measure of memory than the 5-point recall score and has been linked to risk of progression from mild cognitive impairment to dementia.
Question 5: A patient recalls 2 words freely, 2 with category cues, and 1 with multiple choice. What is the Memory Index Score?
- 5
- 9
- 11 (Correct answer)
- 13
Correct answer: 11
(2 x 3) + (2 x 2) + (1 x 1) = 11.
The MIS weights each level of recall differently: free recall counts 3 points per word, category-cued recall counts 2, and multiple-choice recognition counts 1. Here that is 6 + 4 + 1 = 11 out of 15. Note that only the 2 freely recalled words contribute to the standard 30-point MoCA total, giving 2 out of 5 on the delayed recall item.
Question 6: During delayed recall a patient says 'Rose' instead of 'Daisy'. How should the examiner handle this on the MoCA?
- Award the point because a rose is also a flower
- Do not award the point; it is an intrusion, and the examiner may proceed to the category cue (Correct answer)
- Award half a point for a related word
- Repeat the learning trials from the beginning
Correct answer: Do not award the point; it is an intrusion, and the examiner may proceed to the category cue
Only exact target words earn credit; 'Rose' is an intrusion and scores zero for that word.
The MoCA requires exact recall of the five target words. A semantically related word such as 'Rose' for 'Daisy' is recorded as an intrusion and does not earn a point. After free recall is finished, the examiner may give the category cue ('a type of flower') for the missed word, but cued responses are only noted, not scored.
MoCA Memory Recall 2
What is the category cue the examiner gives for the word 'Church' if it is not freely recalled on the MoCA?