MoCA Abstract Thinking 3 — Questions and Answers
Question 1: The two standard word pairs used in the MoCA abstraction task are:
- Dog/cat and apple/orange
- Train/bicycle and watch/ruler (Correct answer)
- Chair/table and pencil/pen
- Car/bus and clock/calendar
Correct answer: Train/bicycle and watch/ruler
The official MoCA uses "train/bicycle" and "watch/ruler" as the two word pairs for the abstraction domain. These pairs were chosen because they have clear categorical similarities.
Question 2: A patient states that a watch and a ruler are alike because "my grandfather had one." This response should be scored as:
- 1 point — personal relevance is acceptable
- 0 points — it is not a valid categorical similarity (Correct answer)
- 0.5 points — partial credit for engagement
- 1 point if the patient appears cognitively intact otherwise
Correct answer: 0 points — it is not a valid categorical similarity
A personal association that does not identify a meaningful categorical or functional relationship earns 0 points. The examiner should not coach during the second pair.
Question 3: Which cognitive ability is MOST directly assessed by the MoCA abstraction task?
- Short-term memory retention
- Abstract thinking and categorical reasoning (Correct answer)
- Working memory capacity
- Verbal fluency
Correct answer: Abstract thinking and categorical reasoning
Abstract thinking involves moving beyond concrete, surface-level descriptions to identify shared conceptual categories, which is what the MoCA abstraction pairs specifically test.
Question 4: How does a score of 0 on both abstraction pairs affect the total MoCA score?
- It reduces the total by 1 point
- It reduces the total by 2 points (Correct answer)
- It has no effect because abstraction is unscored
- It reduces the total by 3 points
Correct answer: It reduces the total by 2 points
The abstraction domain is worth 2 points total. Scoring 0 on both pairs reduces the total MoCA score by 2, which can be clinically meaningful near the normal/impaired cutoff.
Question 5: Why is abstract thinking included in the MoCA rather than just memory tests?
- To make the test longer and more thorough
- Because memory tests are inaccurate
- To detect frontal-executive deficits not captured by memory tasks alone (Correct answer)
- Because abstraction correlates with education level
Correct answer: To detect frontal-executive deficits not captured by memory tasks alone
MCI and early dementia affect multiple cognitive domains beyond memory. Including abstraction allows the MoCA to detect frontal/executive dysfunction that memory tasks alone would miss.
Question 6: According to standard MoCA scoring, which answer earns 1 point for the train/bicycle pair?
- They are both fast
- They are both made of steel
- They are both means of transportation (Correct answer)
- They are both found outdoors
Correct answer: They are both means of transportation
"They are both means of transportation" or "vehicles" correctly identifies the categorical relationship between a train and a bicycle, earning the full 1 point for that pair.
MoCA Abstract Thinking 3
The two standard word pairs used in the MoCA abstraction task are: