Many words have been used to describe Donald Trump's intelligence and mental health, including his own "stable genius", but "perfect score" might be a new one.
When Trump took the Montreal Cognitive Assessment (MOCA), the US President got a perfect score, while most people usually pass with an average 90% correct.
The test results were released by presidential physician Dr. Ronny Jackson, on Tuesday (16 January).
The MOCA is designed to assess people's cognitive ability. It can be used in a variety of ways, including detecting early signs of Alzheimer's disease or small cognitive dysfunction.
Created in 1996, it's a blend of tasks aimed at evaluating someone's concentration, attention, memory, language, calculations, orientation, executive functions and visual skills.
There exists a variant of the test intended for people that are illiterate or with a lower standard of education.
The MOCA is graded on a 30 points scale and takes 10 minutes to complete. The average person usually gets around 27.4, although a normal score would be anything between 26 and above. People scoring less than 26 would have to take other tests in order to completely evaluate their cognitive skills. Someone with an impairment usually scores around 22 or less. People with early onset Alzheimer's can score around 16.
Want to see how you would fare? You'll need a friend to play the examiner for the test below. Don't forget to time yourself when you start.
Montreal Cognitive Assessment Preparation
Click here to get a printable version of the Montreal Cognitive Assessment.
Ask a friend to be your examiner. They should read the 'instructions' exactly as they are written below. Do not read the 'scoring' criteria to the person taking the test.
Set yourself a timer to see how long it takes you to complete the test. It should last around 10 minutes.
Take a breath, get set, and enjoy.
TASK 1: Alternating Trail Making (5 points)
Instructions: The examiner instructs the subject: "Please draw a line, going from a number to a letter in ascending order. Begin here [point to (1)] and draw a line from 1 then to A then to 2 and so on. End here [point to (E)]."
Scoring: Allocate one point if the subject successfully draws the following pattern: 1 −A- 2- B- 3- C- 4- D- 5- E, without drawing any lines that cross. Any error that is not immediately self-corrected earns a score of 0.
TASK 2: Cube
Instructions: The examiner gives the following instructions, pointing to the cube: "Copy this drawing as accurately as you can, in the space below".
Scoring: One point is allocated for a correctly executed drawing.
- Drawing must be three-dimensional
- All lines are drawn
- No line is added
- Lines are relatively parallel and their length is similar (rectangular prisms are accepted)
A point is not assigned if any of the above-criteria are not met.
TASK 3: Clock
Instructions: Indicate the right third of the space and give the following instructions: "Draw a clock. Put in all the numbers and set the time to 10 past 11".
Scoring: One point is allocated for each of the following three criteria:
Contour (1 pt.): the clock face must be a circle with only minor distortion acceptable (e.g., slight imperfection on closing the circle);
Numbers (1 pt.): all clock numbers must be present with no additional numbers; numbers must be in the correct order and placed in the approximate quadrants on the clock face; Roman numerals are acceptable; numbers can be placed outside the circle contour;
Hands (1 pt.): there must be two hands jointly indicating the correct time; the hour hand must
be clearly shorter than the minute hand; hands must be centred within the clock face with their
junction close to the clock centre.
A point is not assigned for a given element if any of the above-criteria are not met.
TASK 4: Naming (3 points)
Instructions: Beginning on the left, point to each figure and say: "Tell me the name of this animal".
Scoring: One point each is given for the following responses: (1) lion (2) rhinoceros or rhino (3) camel or dromedary.
TASK 5: Memory
Instructions: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: "This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember. It doesn't matter in what order you say them".
Mark a check in the allocated space for each word the subject produces on this first trial.
When the subject indicates that (s)he has finished (has recalled all words), or can recall no more words, read the list a second time with the following instructions: "I am going to read the same list for a second time. Try to remember and tell me as many words as you can, including words you said the first time." Put a check in the allocated space for each word the subject recalls after the second trial.
At the end of the second trial, inform the subject that (s)he will be asked to recall these words again by saying, "I will ask you to recall those words again at the end of the test."
Scoring: No points are given for Trials One and Two.
TASK 6: Attention (6 points)
1. Forward Digit Span:
Instructions: Give the following instruction: "I am going to say some numbers and when I am through, repeat them to me exactly as I said them". Read the five number sequence at a rate of one digit per second.
2. Backward Digit Span:
Instructions: Give the following instruction: "Now I am going to say some more numbers, but when I am through you must repeat them to me in the backwards order." Read the three number sequence at a rate of one digit per second.
Scoring: Allocate one point for each sequence correctly repeated, (N.B.: the correct response for the backwards trial is 2-4-7).
Instructions: The examiner reads the list of letters at a rate of one per second, after giving the following instruction: "I am going to read a sequence of letters. Every time I say the letter A, tap your hand once. If I say a different letter, do not tap your hand".
Scoring: Give one point if there is zero to one errors (an error is a tap on a wrong letter or a failure to tap on letter A).
Instructions: The examiner gives the following instruction: "Now, I will ask you to count by subtracting seven from 100, and then, keep subtracting seven from your answer until I tell you to stop." Give this instruction twice if necessary.
Scoring: This item is scored out of 3 points. Give no (0) points for no correct subtractions, 1 point for one correction subtraction, 2 points for two-to-three correct subtractions, and 3 points if the participant successfully makes four or five correct subtractions. Count each correct subtraction of 7 beginning at 100.
Each subtraction is evaluated independently; that is, if the participant responds with an incorrect number but continues to correctly subtract 7 from it, give a point for each correct subtraction. For example, a participant may respond "92 – 85 – 78 – 71 – 64" where the "92" is incorrect, but all subsequent numbers are subtracted correctly. This is one error and the item would be given a score of 3.
TASK 7: Language (3 points)
Instructions: The examiner gives the following instructions: "I am going to read you a sentence. Repeat it after me, exactly as I say it [pause]: I only know that John is the one to help today." Following the response, say: "Now I am going to read you another sentence. Repeat it after me, exactly as I say it [pause]: The cat always hid under the couch when dogs were in the room."
Scoring: Allocate 1 point for each sentence correctly repeated. Repetition must be exact. Be alert for errors that are omissions (e.g., omitting "only", "always") and substitutions/additions
Instructions: The examiner gives the following instruction: "Tell me as many words as you can think of that begin with a certain letter of the alphabet that I will tell you in a moment. You can say any kind of word you want, except for proper nouns (like Bob or Boston), numbers, or words that begin with the same sound but have a different suffix, for example, love, lover, loving. I will tell you to stop after one minute. Are you ready? [Pause] Now, tell me as many words as you can think of that begin with the letter F. [time for 60 sec]. Stop."
Scoring: Allocate one point if the subject generates 11 words or more in 60 sec. Record the subject's response in the bottom or side margins.
TASK 8: Abstraction (2 points)
Instructions: The examiner asks the subject to explain what each pair of words has in common, starting with the example: "Tell me how an orange and a banana are alike". If the subject answers in a concrete manner, then say only one additional time: "Tell me another way in which those items are alike". If the subject does not give the appropriate response (fruit), say, "Yes, and they are also both fruit." Do not give any additional instructions or clarification. After the practice trial, say: "Now, tell me how a train and a bicycle are alike". Following the response, administer the second trial, saying: "Now tell me how a ruler and a watch are alike". Do not give any additional instructions or prompts.
Scoring: Only the last two item pairs are scored. Give 1 point to each item pair correctly answered. The following responses are acceptable:
Train-bicycle = means of transportation, means of travelling, you take trips in both;
Ruler-watch = measuring instruments, used to measure.
The following responses are not acceptable:
Train-bicycle = they have wheels;
Rulerwatch = they have numbers.
TASK 9: Delayed recall (5 points)
Instructions: The examiner gives the following instruction: "I read some words to you earlier, which I asked you to remember. Tell me as many of those words as you can remember." Make a check mark ( √ ) for each of the words correctly recalled spontaneously without any cues, in the allocated space.
Scoring: Allocate 1 point for each word recalled freely without any cues.
TASK 10: Orientation (six points)
Instructions: The examiner gives the following instructions: "Tell me the date today". If the subject does not give a complete answer, then prompt accordingly by saying: "Tell me the [year, month, exact date, and day of the week]." Then say: "Now, tell me the name of this place, and which city it is in."
Scoring: Give one point for each item correctly answered. The subject must tell the exact date and the exact place (name of hospital, clinic, office). No points are allocated if subject makes an error of one day for the day and date.
Sum all subscores listed on the right-hand side. Add one point for an individual who has 12 years or fewer of formal education, for a possible maximum of 30 points. A final total score of 26 and above is considered normal.
Around 16: Cognitive health of an Alzheimer's sufferer.
Around 22: Cognitive health of someone with mild cognitive impairment (MCI)
Above 26: Normal
So, how did you do?