MoCA Verbal Fluency (Letter Fluency) — Questions and Answers
Question 1: In the MoCA verbal fluency task, what is the examinee asked to do?
- Name as many animals as possible in 60 seconds
- Name as many words as possible beginning with the letter 'F' in 60 seconds (Correct answer)
- Repeat a list of five words as many times as possible in 60 seconds
- Name as many items in a given category (e.g., fruits) as possible in 60 seconds
Correct answer: Name as many words as possible beginning with the letter 'F' in 60 seconds
The MoCA verbal fluency task is a phonemic (letter) fluency task: the examinee generates as many words as possible beginning with the letter 'F' in 60 seconds. Proper nouns and variations of the same root word are excluded.
Question 2: What is the minimum number of words beginning with 'F' an examinee must produce in 60 seconds to earn the point on the MoCA verbal fluency task?
- 7 words
- 9 words
- 11 words (Correct answer)
- 15 words
Correct answer: 11 words
The cutoff for earning 1 point on the MoCA verbal fluency task is generating 11 or more words beginning with 'F' within 60 seconds. This threshold was established in the original MoCA normative study.
Question 3: Under which MoCA domain is the verbal fluency task classified?
- Memory
- Language (Correct answer)
- Attention
- Orientation
Correct answer: Language
The verbal fluency task is classified under the Language domain of the MoCA, alongside sentence repetition. However, it also has a significant executive function component due to the strategic, self-organized retrieval process required.
Question 4: Which of the following responses would NOT be counted during the MoCA verbal fluency task?
- "Fast"
- "France" (Correct answer)
- "Furniture"
- "Friendly"
Correct answer: "France"
'France' is a proper noun and is explicitly excluded from the MoCA verbal fluency task. Proper nouns (names of people, places, countries, etc.) are not counted regardless of their starting letter.
Question 5: What neurological conditions most commonly impair performance on the MoCA letter fluency task?
- Cerebellar lesions only
- Pure visuospatial disorders without cognitive involvement
- Frontal lobe dysfunction, MCI, and early dementia (Correct answer)
- Peripheral hearing loss only
Correct answer: Frontal lobe dysfunction, MCI, and early dementia
Letter fluency is particularly sensitive to frontal lobe dysfunction, which impairs strategic word retrieval and monitoring. It is commonly reduced in MCI, Alzheimer's disease, frontotemporal dementia, and Parkinson's disease with cognitive impairment.
Question 6: How many total points is the verbal fluency task worth on the MoCA?
- 3 points
- 2 points
- 1 point (Correct answer)
- 0 points — it is observed but not scored
Correct answer: 1 point
The verbal fluency task is worth 1 point, awarded when the examinee generates 11 or more words beginning with 'F' in 60 seconds. It is a pass/fail item contributing to the Language domain score.
MoCA Verbal Fluency (Letter Fluency)
In the MoCA verbal fluency task, what is the examinee asked to do?