MoCA Visual Impairment

MoCA-VI

What is it?

The MoCA-VI is an adapted version of the standard MoCA, designed to facilitate the detection of cognitive impairment in adults with vision loss. The visual components of the original MoCA have been modified to maximize sensitivity and specificity for identifying cognitive deficits.

Purpose: It is intended to screen for mild cognitive impairment in individuals with visual impairment, ensuring that assessment results reflect cognitive abilities rather than visual limitations.

Administration time

Approximately 10 minutes.

Setting

The MoCA-VI should be administered in a clinical setting or other calm, controlled, distraction-free environment.

Form

Paper-based; the examiner presents standardized stimuli, either auditory or tactile, and records the examinee’s responses directly on the test sheet.

Cost

Freely available for clinical and educational use; a license is required for commercial use.

Cognitive Domains Assessed

The MoCA-VI assesses similar cognitive domains as the original MoCA, without visuospatial skills:

Memory

Executive functions

Orientation

Language

Attention

Abstract reasoning

Naming

Results

The MoCA-VI is scored manually, 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 25 or higher are generally considered within normal limits.

Psychometric Properties

Property	Summary of Findings Across Studies	Typical Values / Ranges	Interpretation
Diagnostic Accuracy	Effectively distinguishes dementia from normal cognition in adults with vision impairment; adapted items optimize detection.	AUC ≈ 0.96; Cut-off ≤ 24 → Sensitivity 95.9%, Specificity 92.4%	Excellent screening tool for cognitive impairment in adults with vision loss.
Test–Retest Reliability	Scores are consistent across repeated administrations.	ICC ≈ 0.84	Good temporal stability; results are reliable over time.
Score Equivalence / Independence from Vision	Adapted spoken items minimize influence of visual ability on performance.	-	Scores reflect cognitive ability rather than visual acuity.
Impact of Visual Impairment on Standard MoCA	Standard MoCA scores decrease with simulated or actual vision loss.	Score declines noted at 20/80–20/200 simulated vision	Standard MoCA may underestimate cognition in visually impaired adults, supporting use of MoCA-VI.

References

Dawes, P., Reeves, D., Yeung, W. K., Holland, F., Charalambous, A. P., David, R., Helmer, C., Laforce, R., Martins, R. N., Politis, A., Pye, A., Russell, G., Sheikh, S., Sirois, M.-J., Sohrabi, H. R., Thodi, C., Gallant, K., Nasreddine, Z., & Leroi, I. (2025).
Development and validation of the Montreal Cognitive Assessment for people with vision impairment (MoCA-VI). Psychological Assessment, 37(5), 1–13. https://doi.org/10.1037/pas0001283
Stark, Z., Morrice, E., Murphy, C., Wittich, W., & Johnson, A. P. (2023).
The effects of simulated and actual visual impairment on the Montreal Cognitive Assessment. Aging, Neuropsychology, and Cognition, 30(4), 523–535. https://doi.org/10.1080/13825585.2022.2055739