Conférence MoCA #23 :
De JAMA à GUIDE : 20 ans de parcours pour faire progresser les soins aux personnes atteintes de démence (Malaz Boustani, MD, MPH) - jeudi 5 juin 2025, 12 h 00 HAE
The MoCA Audiovisual provides visual stimuli and supplementary instructions to support the administration of the MoCA Full (versions 8.1, 8.2, and 8.3) via a videoconference platform.
Purpose: To enable remote administration of the MoCA when in-person testing is not feasible (e.g., due to geographic distance, mobility limitations, or public health considerations), using videoconference platforms.
Administration time
Similar to the standard MoCA (about 10 minutes), with videoconference administration possibly adding 2–3 minutes for guidance.
Setting
The examinee should be situated in a calm, and controlled environment, free from distractions such as television, pets, or other people. The space should be well-lit to ensure visibility of the examinee and any written responses. The examinee should be comfortably seated at a table or desk with paper, pencil and eraser readily available for drawing tasks. Additionally, the technology setup—including camera, microphone, and internet connection—should be stable and tested beforehand to minimize interruptions during the assessment.
Form
The MoCA Audiovisual is a paper-based test administered remotely via a secure videoconference platform. The examiner presents stimuli and observes responses live, which may be shown on paper or given verbally and recorded by the examiner.
Cost
Freely available for clinical and educational use; a license is required for commercial use.
The MoCA Audiovisual is scored manually, following the same procedures as the standard MoCA, in accordance with the guidelines provided in the instructional PDF. The total score ranges from 0 to 30 points, with higher scores indicating better cognitive functioning. Scores of 26 or higher are generally considered within normal limits.
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| Property | Summary of Findings Across Studies | Typical Values / Ranges | Interpretation |
|---|---|---|---|
Score Equivalence to Full MoCA | No significant differences were found between videoconference and in-person MoCA total scores. Subdomain agreement was generally moderate to substantial, although some domains (e.g., language) showed lower agreement. | ICC = 0.89 (Zadik et al., 2023); difference in means <0.2 points (EHBS, 2023) | Remote MoCA provides equivalent total score results to in-person administration. Subdomain scores may vary slightly, particularly language. |
Internal Consistency / Reliability | Limited reporting on reliability; available data indicate good test-retest reliability and only small score variations in small cohorts. | ICC = 0.89; small variation between test-retest (<1 point) | Remote MoCA demonstrates good reliability, though internal consistency (e.g., Cronbach’s alpha) is less well-documented. |
Sensitivity to Cognitive Impairment | Remote MoCA effectively distinguishes cognitive impairment in older adults and in populations with specific neurological conditions. | Sensitivity = 0.77 (Carvalho et al., 2024) | The audiovisual MoCA can effectively detect cognitive impairment in clinical populations. |
Specificity | High specificity has been reported for the remote MoCA. | Specificity = 0.92 (Carvalho et al., 2024) | Remote MoCA has a low rate of false positives for cognitive impairment. |
Cross-Cultural Validity | Normative data are available for different language versions, and validation has been conducted in diverse populations, including those with neurological conditions. | Norm-based Z-scores available for specific populations; cut-off ≥23 (Brazil) | Remote MoCA demonstrates validity across different cultures/ languages, though normative data remain population-specific. |
Administration Time | Administration time is similar to the standard MoCA Full (~10–15 minutes), with a videoconference setup potentially adding 2–3 minutes for instructions. | ~10–18 minutes total | Remote administration is feasible within typical MoCA time frames. |