Your adjusted MoCA score (with education correction if applicable) indicates cognitive function across multiple domains. A score of 26 or above is considered normal. Scores of 18-25 suggest mild cognitive impairment (MCI), which may represent early neurodegenerative disease, vascular cognitive impairment, or other treatable causes of cognitive decline. Scores of 10-17 suggest moderate cognitive impairment consistent with dementia. Scores below 10 suggest severe cognitive impairment.

A low MoCA score is not a diagnosis — it is a screening result that warrants further evaluation. Many conditions can cause cognitive impairment, including depression, medication side effects, sleep apnea, thyroid dysfunction, vitamin B12 deficiency, and normal pressure hydrocephalus, some of which are reversible. A comprehensive evaluation including neuropsychological testing, laboratory workup, and neuroimaging may be appropriate.

Use the MoCA score interpreter when a Montreal Cognitive Assessment has been administered and you need to contextualize the result. The MoCA is recommended as a first-line cognitive screening tool for patients with subjective memory complaints, for older adults during routine health evaluations, and for patients with conditions associated with cognitive decline (stroke, Parkinson disease, heart failure, diabetes).

It is also used for serial monitoring of cognitive function over time — for example, tracking progression in patients with known MCI or assessing response to cholinesterase inhibitor therapy. A decline of 2 or more points on serial testing may be clinically meaningful, though practice effects can artificially inflate repeat scores.

The MoCA is a screening tool, not a diagnostic instrument. A score below 26 does not confirm dementia or MCI, and a score of 26 or above does not exclude it. The standard cutoff of 26 has high sensitivity but lower specificity, meaning some cognitively normal individuals will screen positive. Some experts have suggested that a cutoff of 23 may be more appropriate in certain populations to reduce false positives.

The MoCA is influenced by education, language, and cultural factors. The 1-point education correction for individuals with 12 or fewer years of education is a rough adjustment and may not fully account for educational disparities. Performance can also be affected by anxiety, fatigue, sensory impairments (hearing or vision), and the testing environment. The MoCA should not be used as a standalone tool for major clinical decisions such as driving fitness or capacity assessments without comprehensive neuropsychological evaluation.