General introduction 27 1 Table 4. DSM 5 descriptions of the cognitive domainds Domains (DSM-5) Description Examples Complex attention involves sustained attention, divided attention, selective attention, and information processing speed Trail making test Serial seven Digit span Months backwards Executive ability involves planning, decision making, working memory, responding to feedback, error correction, overriding habits, and mental flexibility Proverb test Letter Fluency (phonemic) Language involves expressive language and receptive language naming, fluency, grammar, and syntax repetition Learning and memory involves immediate memory, recent memory (free recall, cued recall, and recognition memory), and long term memory Memory test of words (verbal memory) or pictures (visual memory) Perceptual - Motor - Visual perception praxis- Conception and planning of a motor act in response to an environmental demand involves picking up the telephone, handwriting, using a fork/spoon Clock drawing test Social cognition involves recognition of emotions and behavioural regulation, social appropriateness in terms of dress, grooming, and topics of conversation Recognizing emotions Theory of mind Although the MoCA tests several domains, it does not test all of the above-mentioned cognitive domains. Below, we explain the cognitive domains used by the MoCA per item. The instructions are read out aloud. There should not be any aid from the staff or from the next of kin. If a patient corrects their mistake (immediately) by themselves, the points to be gained will be allocated. Table 5. The domains the MoCA tests and how. Domains (MoCA) Max 30 points Description/ Item MoCA test example (V7.1) Visuospatial and Executive functioning max 5 points: With a pencil on the paper Alternating Trail Making, 1 point The patient is asked to draw a line alternating between numbers and letters in increasing order. The letters and numbers are scattered or ‘not in an orderly placed’ on the test field. Visuo-constructional Skills, 1 point The patient is asked to copy a three-dimensional figure: a cube. Visuo-constructional Skills, 3 points The patient is asked to draw a clock including the hands on ten past eleven. Points are scored for the shape (1), digits in order (1) and putting the hands in the correct place (1).
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