Montreal Cognitive Assessment (MoCA)

When it activates

Scribeable activates a calculator from the encounter. The Montreal Cognitive Assessment (MoCA) can activate when the transcript or pasted chart context documents any of these:

• Cognitive screening
• Dementia evaluation
• Memory loss assessment
• Mild cognitive impairment screening
• Cognitive decline monitoring

Note-type scope: it activates on notes whose subject resolves to psychiatry, neurology, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.

Inputs the note needs

8 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

7 domains: Visuospatial/executive (5), Naming (3), Attention (6), Language (3), Abstraction (2), Delayed recall (5), Orientation (6). Total 0-30. Add 1 point if <=12 years education.

Interpretation

>=26: Normal cognition. 18-25: Mild cognitive impairment — further neuropsychological testing, lab workup (TSH, B12, RPR), consider neuroimaging. 10-17: Moderate cognitive impairment — probable dementia, comprehensive evaluation. <10: Severe cognitive impairment. MoCA detects MCI better than MMSE (sensitivity 90% vs 18%). Domain scores help localize deficits. Serial testing tracks progression (use alternate forms).

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Nasreddine 2005.

• Nasreddine ZS et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairmentNasreddine et al. (MoCA) 2005 · 2005 · Level I · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Montreal Cognitive Assessment (MoCA) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a Montreal Cognitive Assessment (MoCA) value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.

Classified as a questionnaire: a patient-reported or clinician-rated instrument, where a spare activation carries low harm.

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Can activate in: Psychiatry, Neurology, Geriatrics.