President Donald Trump has boasted in several recent television appearances about his performance on a screening test aimed at evaluating mild cognitive impairment or early dementia.
It’s unclear if Trump, 74, took the test again, but in 2018 he received the Montreal Cognitive Assessment (MoCA) with Dr. Ronny Jackson, the former White House doctor, and at which point he scored Perfect of 30 out of 30.
The MoCA test was created by the Canadian neurologist Dr. Ziad Nasreddine. The exam has 30 questions and is designed to take 10 minutes. Questions include drawing a clock, copying a picture of a cube, and identifying pictures of animals.
“I created the test in 1996 as a screening test where we ask the patient various questions,” Nasreddine told NBC News. “Each question is accessing a different part of the brain in terms of cognition.”
It is a test administered only by doctors and not intended for the general public.
“It has to be interpreted by a doctor with expertise in cognitive disorders and cognition,” said Nasreddine.
A score greater than 26 is considered normal, while 18-25 is considered mild cognitive impairment, 10-17 is considered moderate cognitive impairment. A score below 10 is considered severe cognitive impairment.
Trump recently cited his performance on the test as a challenge to Joe Biden, 77, the alleged 2020 Democratic presidential candidate. On Wednesday, after a press conference, Trump spoke to Fox News contributor Dr. Marc Siegel, during which he described the memory portion of the test.
“It is as if you were: person, woman, man, camera, television. So they say, ‘Could you repeat that?’ So I said, ‘Yes. So it is person, woman, man, camera, television. ‘Okay, that’s great. If you put it in order, you get extra points. ‘”
In an interview with Fox News’ Chris Wallace on Sunday, Trump said the exam is becoming increasingly difficult.
“Yes, the first few questions are easy, but I bet you couldn’t even answer the last five questions. I bet you couldn’t, the last five questions get very difficult, ”he told Wallace.
Some of the last five questions Trump was referring to include naming the time and place he is in, as well as repeating a series of words he was asked to remember earlier in the test.
Dr. Lawrence Honig, a neurologist and one of the directors of the Alzheimer’s Disease Research Center at Columbia University, said that while the test is a good indicator, it is not perfect. He has seen patients with a dementia score greater than 26 and has seen patients without a dementia score below 26.
This is because there are often confounding factors, such as level of education and whether the test is conducted in the person’s native language. A person with a secondary education in the United States should be between 26 and 30 years old, said Honig.
What does it mean to write down 30 of 30?
“If you are looking for Alzheimer’s disease, you would be reassured to say there are no signs of Alzheimer’s disease,” Nasreddine said, referring to a perfect score on the test.
The Montreal test is not a routine screening test in the same way that a colonoscopy or mammogram is, said Honig.
“There is no broad consensus that we should give MoCA to people as part of their annual general wellness or physical exam,” he said.
Symptoms that could cause someone to test you include:
- repeating patients
- lose your car keys frequently
- forgetting recent events
- multiple instances of forgetting conversations
Nasreddine also cautions that this test is not intended to be an IQ test and is not used as a measure of someone’s intelligence.
“There are no studies demonstrating that this test correlates with IQ tests,” he said. “The goal was not to determine people who have a low IQ level. Therefore, we cannot say that this test reflects someone’s IQ.”
