The MoCA assesses several cognitive domains. A less than satisfactory score would suggest the need for referral to a specialist for further assessment. In my opinion and experience, the MoCA is suitable and very useful as a convenient screening tool for use in the occupational health clinic by occupational health doctors and nurses. The test may be administered by anyone who understands and follows the instructions but the website states that only a health professional with expertise in the cognitive field should interpret the results. MoCA is free for use by universities, foundations, health professionals, hospitals, clinics and public health institutes. A score of 26 or above is considered normal. The assessment consists of a 30 point test on a single side of A4 and can be administered in 10min. A comprehensive website provides the test, instructions, normative data, references, frequently asked questions and permissions and updates. The MoCA may be useful in the occupational health setting for detecting MCI or early dementia especially as the workforce ages. The prevalence of MCI in population-based epidemiological studies ranges from 3 to 19% in adults older than 65 years and more than half progress to dementia within 5 years. MCI is a syndrome defined as cognitive decline greater than expected for an individual’s age and education level but that does not interfere not ably with activities of daily life. It is answered by the patient, family, or caregiver to indicate the presence of cognitive impairment.The Montreal Cognitive Assessment (MoCA) was developed by Dr Ziad Nasreddine in Montreal, Canada in 1995 for the detection of mild cognitive impairment (MCI) by health professionals. The questionnaire is useful to assess and monitor functional changes over time. The Functional Activities Questionnaire calculates the extent of the patient’s ability to engage in instrumental activities of daily living. Both anxiety and depression may affect cognitive assessment scores. This tool is a valid screening tool for gauging severity of generalized anxiety symptoms. More information about PHQ-9 can be found here. The PHQ-9 can be useful in clinical practice to assess depression severity and its symptoms. A score of greater than five indicates further evaluation. Score one point when the patient answer matches the test answer. The Geriatric Depression Scale can be useful for patients who have mild-to-moderate symptoms of dementia. Its use is granted by Washington University for clinical care purposes. No formal training is needed to administer the test. In combination with the Mini-COG, the AD8 is effective for detecting early cognitive change. The test consists of eight yes-or-no questions about changes in the person’s thinking, memory, and behavior. This brief 3-minute test was originally designed as an informant screening tool but has also been validated as a direct questionnaire for the patient. A one-hour Training & Certification module supports MoCA’s validity and was designed for busy medical professionals. Both an app and paper versions are available. It is easy to administer and score, and the results can be interpreted by the health provider with minimal training. The Montreal Cognitive Assessment is a quick and easy instrument that can be adapted for use in the clinical setting. This paper tool is helpful for clinics that serve linguistically diverse populations that have varying education levels. This validated short cognitive screening instrument is designed to reduce the impact of language and cultural differences on the results of screened individuals. Rowland Universal Dementia Assessment Scale (RUDAS) Training for use of this tool takes about ten minutes. This is a free tool and is available in many languages. The Mini-Cog is a three-minute instrument for the patient that consists of two components: a three-item recall test for memory and a clock drawing test.
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