MoCA Orientation and Attention — Questions and Answers
Question 1: How many points is the orientation section of the MoCA worth?
- 4
- 5
- 6 (Correct answer)
- 8
Correct answer: 6
Orientation has six items worth one point each.
The MoCA orientation section asks for the date, month, year, day of the week, place, and city. Each correct answer earns one point, for a maximum of six. It is the final section of the test and is usually the easiest, so errors here are often meaningful.
Question 2: A patient being tested on the 16th gives the date as the 15th. How is the date item scored on the MoCA?
- Full credit, since one day of error is allowed
- Half credit
- No credit; the date must be exact (Correct answer)
- Full credit if the month and year are correct
Correct answer: No credit; the date must be exact
The MoCA requires the exact date; an error of one day scores zero for that item.
The MoCA instructions state that the patient must give the exact date and the exact place. No point is given if the patient is off by even one day on the date or the day of the week. This is stricter than some other cognitive screens and should be applied consistently by examiners.
Question 3: What answer does the MoCA accept for the 'place' orientation item?
- Any building or general location
- The specific name of the hospital, clinic, or office where testing is done (Correct answer)
- The patient's home address
- The country the test is being given in
Correct answer: The specific name of the hospital, clinic, or office where testing is done
The patient must name the specific place of testing, such as the clinic or hospital.
For the place item, the MoCA asks the patient to name the exact location of the test, such as the name of the hospital, clinic, or office. A vague answer is not accepted. The city item is scored separately and asks which city or town the patient is currently in.
Question 4: In the MoCA vigilance (letter tapping) task, what should the patient do?
- Tap the table each time the letter A is read aloud (Correct answer)
- Repeat every letter after the examiner
- Write down each letter they hear
- Tap once for every vowel
Correct answer: Tap the table each time the letter A is read aloud
The patient taps their hand once whenever they hear the letter A.
The examiner reads a string of letters at a rate of one per second, and the patient must tap the table (or their hand) each time the letter A is spoken. The task measures sustained attention and response inhibition. Errors include missing an A (omission) or tapping on a different letter (commission).
Question 5: How is the MoCA vigilance task scored?
- 1 point if there are no errors at all
- 1 point if there are one or fewer errors (Correct answer)
- 2 points, one for each half of the letter string
- 1 point per correct tap
Correct answer: 1 point if there are one or fewer errors
One point is awarded if the patient makes zero or one error.
The letter tapping task is worth one point. The patient receives the point if they make no errors or only one error, counting both missed A's and taps on wrong letters. Two or more errors result in a score of zero for the task.
Question 6: At what pace should the examiner read the letters aloud in the MoCA vigilance task?
- As fast as possible
- One letter per second (Correct answer)
- One letter every three seconds
- At whatever speed the patient prefers
Correct answer: One letter per second
The letters are read at a rate of one per second.
Standardized timing is important for the MoCA attention items. Both the digit sequences and the vigilance letter string are read at one item per second. Reading faster or slower changes the difficulty of the task and can make the score less comparable to normative data.
MoCA Orientation and Attention
How many points is the orientation section of the MoCA worth?