Honestly, I’m not usually one to brag, but I’m thinking that, in this case, maybe I should. If you’ve been paying attention to the news, you know that the President for the past few days has bragged that he “recently” took a mental competence test and it was “very hard,” especially the last five questions. Now the President not only took the (very hard) test — get this — he “aced” it!!
While no one knows for sure, it appears that the test he is referring to is the Montreal Cognitive Assessment (MoCA) test.
Ok — are you ready for this? — I took that exact same test. Why? Because when you get to be my age and apply for life insurance, the insurance companies not only require you to have a physical exam, they also want to be sure you’re not looney. (Maybe one reason they do this is because they can’t imagine why anyone as old as I am would want to buy a life insurance policy — unless they’re crazy.)
The MoCA screening test was designed about 20 years ago as a possible replacement for another test — the Mini-Mental State Examination, that had been widely used since the 1970s to look for outright dementia. The MoCA test is used in all 31 of the National Institute on Aging’s Alzheimer Disease Centers. The MoCA test is available on the Internet — just search for it. It’s the complete test, just like the one that I and Donald took.
The MoCA test gained acceptance because it is a bit harder that the Mini-Mental and can pick up problems that occur in the earliest stage of dementia, called mild cognitive impairment (MCI) — a sort of “everyday forgetfulness.” About 1 in 5 people over age 65 have MCI and roughly one-third of those will develop Alzheimer’s disease within five years.
One of the things I remember from when I took the MoCA was an exercise to draw a clock with the hands pointing to 11:10. I, like the President, was complimented on being able to accomplish such a feat. My “tester” indicated that many people couldn’t do this — correctly — usually the major mistake was mixing up the hour and minute hands.
Many doctors today use cognitive screenings of some type — usually a sub-set of the MoCA questions. I have never had such a test in our doctor’s office, probably because I don’t use Medicare. Congress instituted a requirement that Medicare cover a brief cognitive screening test as part of the annual wellness exam.
Some people simply don’t want to know if they are developing dementia, but those that do are often given a neuropsychological test much more difficult and intense than the MoCA. And doctors will repeat the test over time. These tests aren’t like PSA tests, or colonoscopies that identify issues right away and allow for a diagnosis and treatment to begin.
So — I may not be a genius, but I must be very smart, since I don’t think I missed any of the questions on my mental competence test. If you find yourself in a situation that you may be required to take the MoCA, feel free to give me a call if you need some coaching. Of course you could call the President, but with his busy schedule, it might take him a while to get back to you…. I’m just hanging around the house because of COVID-19.
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