Psychological and neuropsychological testing

Meet the exam scene

A registrar presents a 72-year-old with a MoCA of 22 and writes: "mild dementia, start donepezil." The examiner leans in: "What does a MoCA of 22 actually prove, and what must you exclude first?"^[2]

The honest answer: a MoCA of 22 is a finding — a screen that flags possible cognitive impairment and warrants further assessment. It is not a dementia diagnosis. Before any such label, you exclude delirium, you weigh education and language, and you build a syndrome from history, course, function, and aetiology.^[2][5][7]

This topic is the cognitive-testing ladder — screens, batteries, intellectual and personality testing, and the effort-testing that protects every interpretation. The symptom scales (PHQ-9, PANSS) live in the rating-scales topic; here we own cognition and neuropsychology.^[1][2][8]

References18ShowHide

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3. [3]Carson N, Leach L, Murphy KJ A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores Int J Geriatr Psychiatry, 2018.PMID 28731508
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