Instrument template · CognitionUpdated September 28, 2026

MoCA eCRF template for cognitive screening and endpoints

The Montreal Cognitive Assessment is a 30-point, ten-minute screen for mild cognitive impairment. The test itself happens on paper or a licensed digital version; the eCRF captures domain scores, the education adjustment, the version used and who rated it.

  • Seven domain scores
  • Version tracked per visit
  • Licence recorded on the form

Free sandbox · No credit card · 21 CFR Part 11 aligned

MoCA · Screening
Subject 004-0021 · Version 8.1 · Rater: certifiedDraft

Domain scores

Visuospatial / executive (0 to 5)

4

Naming (0 to 3)

3

Attention (0 to 6)

5

Delayed recall (0 to 5)

2

12 years of education or fewer?

NoYes (+1 point)

Total score (0 to 30)

24

Within range 0 to 30

Paper test sheet stays the source document

MoCA at a glance

  • Published by Nasreddine and colleagues in 2005 to detect mild cognitive impairment, where the MMSE is less sensitive.
  • 30 points across seven domains: visuospatial/executive (5), naming (3), attention (6), language (3), abstraction (2), delayed recall (5) and orientation (6).
  • One point is added for 12 years of education or fewer. A total of 26 or more is generally considered normal.
  • Alternate versions exist for repeat testing, which matters in longitudinal trials where participants would otherwise learn the word list.
  • The MoCA is copyrighted. Use requires permission and, for many users, training and certification from MoCA Cognition. Commercial and trial use is licensed.

The instrument

What the MoCA measures

The MoCA is a brief, clinician-administered test covering the cognitive domains most affected early in neurodegenerative and vascular disease: executive function, attention, memory, language, visuospatial ability, abstraction and orientation. It takes about ten minutes and produces a single 0 to 30 score, which is why it is widely used as an eligibility criterion in Alzheimer's, Parkinson's and cognitive health trials and as a secondary outcome in many others.

The test includes drawing and copying tasks (a clock and a cube, for example) and a trail-making item, so the raw material is visual. In most trials the completed test sheet is the source document, and the eCRF records the scores taken from it. That division keeps the scored data structured and verifiable while the source sheet stays available for source data verification.

Scoring and the education point

Domain scores are added to give a total out of 30, and one point is added if the participant has 12 or fewer years of formal education (up to the maximum of 30). A total of 26 or above is generally regarded as normal, but many studies set their own eligibility ranges, and cut-offs vary with age, education and language. Put the exact rule in the protocol and apply it consistently.

Alternate versions

Repeating the same version every few months lets participants learn the memory words and naming animals, inflating later scores. Alternate versions with different items are available for repeat testing. Record which version was used at each visit, and follow the rotation your protocol specifies.

MoCA total · Subject 004-0021

Screening total (with education point)

24 / 30

18 to 25
0-17 Below 1818-25 18 to 2526-30 26+ normal
Visuospatial / executive4 / 5
Attention5 / 6
Delayed recall2 / 5
Orientation6 / 6

Structure

MoCA domains and maximum points

DomainMax pointseCRF field
Visuospatial / executive5Number, range 0 to 5
Naming3Number, range 0 to 3
Attention6Number, range 0 to 6
Language3Number, range 0 to 3
Abstraction2Number, range 0 to 2
Delayed recall5Number, range 0 to 5
Orientation6Number, range 0 to 6
Education adjustment+1Single choice: 12 years or fewer
Total30Number, range 0 to 30
Version usedn/aDropdown of licensed versions
Administration date and ratern/aDate field; rater from the audit trail

This page describes the MoCA's structure only. Obtain the test, instructions, versions and licence from MoCA Cognition.

Licensed instruments

Record the licence on the form itself

Capture lets you keep licence details on any licensed instrument form: licence number, holder and expiry. Until the licence is recorded the form shows a staff-only watermark, and if a licence lapses Capture blocks new data collection on that form rather than letting the study quietly go out of compliance.

  • Licence number, holder and expiry per form.
  • Staff-only watermark until the licence is recorded.
  • New data collection blocked if the licence lapses.
PROMIS SF v1.0 · Fatigue 8a · Settings

Copyright & licence

Approval pending
Licence required

Licence number

Not recorded

Expiry date

Not recorded

Watermark shown to staff only. Participants never see it.

Rater consistency

Know who scored every visit

Inter-rater variability is one of the largest sources of noise in cognitive endpoints. Every value entered in Capture is attributed in the field-level audit trail, so you can check that the same certified rater assessed a participant across visits, and range checks catch domain scores outside their maximum at entry.

  • Range edit checks on every domain and on the total.
  • Rater attribution on every value, with old and new values and the reason for any change.
  • SDV set on the total and the domains most prone to scoring errors, such as delayed recall.
Audit trail software

Weight changed 68.0 to 68.5 kg

Site coordinator · Reason: Transcription error

9f2c…a71e

Query Q-0014 answered on Weight

Site coordinator · Reason: Source checked

4b8d…c203

Vital signs form locked

Data manager · Reason: Visit cleaned

e61a…58f0
Verify chain Intact

Set up a MoCA form with range checks

Build the domain fields, record the licence and test with sample scores in the free sandbox.

Build your MoCA form free

Choosing an instrument

MoCA or MMSE?

Both are 30-point screening tests, and many dementia trials use one of them for eligibility. The MoCA includes more demanding executive and memory tasks, which makes it more sensitive to mild cognitive impairment; the MMSE has a longer track record in Alzheimer's disease trials and is often used to define mild or moderate dementia. For efficacy in Alzheimer's disease, trials typically rely on longer instruments such as the ADAS-Cog rather than either screen.

Whichever you choose, keep it consistent across the program so eligibility thresholds are comparable between studies. See EDC for Alzheimer's and dementia trials for how cognitive batteries fit together in a study.

FAQ

Questions about this template

Something not covered here? Ask us directly.

How is the MoCA scored?

Seven domain scores are added for a total out of 30, and one point is added for participants with 12 or fewer years of education. A total of 26 or above is generally considered normal.

Is the MoCA free for clinical trials?

No. The MoCA is copyrighted and trial and commercial use is licensed by MoCA Cognition, which also runs training and certification for users.

Should the eCRF capture item-level or domain-level scores?

Most trials record domain scores and the total, with the completed test sheet as the source document. Record item level only if your analysis needs it.

Why record the MoCA version?

Alternate versions reduce learning effects on repeat testing. Recording the version at each visit shows the protocol's rotation was followed.

Can Capture track the licence?

Yes. Licence number, holder and expiry can be recorded on the form, and data collection is blocked if the licence lapses.

Does this page include the MoCA test?

No. It describes the structure and how to capture scores. Obtain the test from MoCA Cognition.

Capture cognitive scores you can defend

Build a MoCA form with range checks and licence tracking. Free sandbox, no credit card.

Build your MoCA form free