Development and validation of the Montreal Cognitive Assessment for People with Vision Impairment (MOCA-VI)

Topic: Risk, prevention and care in population studies

Vision impairment is common among older adults and affects dementia screening assessments, which include visually presented items. We developed and validated a version of the Montreal Cognitive Assessment (MoCA) for people with vision impairment that includes all the cognitive domains included in the standard MoCA. Visual components of the MoCA were adapted by developing alternative spoken forms. We used both individual item analysis and item substitution to identify the optimal set of alternative items for inclusion in the Montreal Cognitive Assessment for People With Vision Impairment (MoCA-VI) in place of the original items to maximize sensitivity and specificity for dementia. We evaluated the performance and reliability of the final tool, including adjustments for demographic factors. One hundred twenty-eight participants with vision impairment (presenting distance visual acuity worse than 6/12), 79 cognitively healthy and 49 with dementia, completed the adapted MoCA. An additional 86 participants with normal vision completed the standard MoCA and alternative items to assess score equivalence and independence from vision impairment. Twenty-six participants were retested 2-4 weeks after initial testing. With the optimal item set, the final MoCA-VI had an area under the curve of 0.96 (95% CI [0.93, 0.99]). At a cut point of 24 points or less, sensitivity was 95.9%, with a specificity of 92.4%. The intraclass correlation for test-retest reliability was 0.84 (95% CI [0.81, 0.96]). The MoCA-VI is a specific and reliable test for possible dementia among adults with vision impairment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Key findings

• With the optimal item set, the final MoCA-VI had an area under the curve of 0.96 (95% CI [0.93, 0.99]).
• At a cut point of 24 points or less, sensitivity was 95.9%, with a specificity of 92.4%.
• The intraclass correlation for test-retest reliability was 0.84 (95% CI [0.81, 0.96]).
• The MoCA-VI is a specific and reliable test for possible dementia among adults with vision impairment.
• (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Why it matters

This study developed and validated a version of the MoCA for people with vision impairment, which showed high sensitivity and specificity for possible dementia. It is a screening tool for detecting possible dementia and does not address treating, curing or preventing the disease.

New to this subject? Start with our plain-English guide: Getting a diagnosis →

Study details

• Participants86
• Effect size95.9%; 92.4%
• Evidence strengthLow

Read the original

• DOI: 10.1037/pas0001357
• PubMed: 39946630
• Original source →
• Free full text: Research Explorer (The University of Manchester) →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{dawes2025-39946630,
  author  = {Dawes, Piers and Reeves, David J. and Yeung, Wai Kent and Holland, Fiona and Charalambous, Anna Pavlina and David, Renaud and Helmer, Catherine and Keay, Lisa J. and others},
  title   = {{Development and validation of the Montreal Cognitive Assessment for People with Vision Impairment (MOCA-VI)}},
  journal = {Psychological Assessment},
  year    = {2025},
  doi     = {10.1037/pas0001357},
  pmid    = {39946630},
  url     = {https://doi.org/10.1037/pas0001357}
}

Related studies in Getting a diagnosis

• Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis Psychiatria polska · 2016-10-01 · usefulness score 54/100
• The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke Journal of the neurological sciences · 2010-12-01 · usefulness score 64/100
• The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment Journal of the American Geriatrics Society · 2005-04-01 · usefulness score 60/100
• Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment Geriatrics & gerontology international · 2010-02-04 · usefulness score 53/100
• Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal Cognitive Assessment Journal of geriatric psychiatry and neurology · 2008-06-01 · usefulness score 46/100
• NUCOG10: The development and validation of a short form of the NUCOG cognitive assessment tool Australian & New Zealand Journal of Psychiatry · 2026-01-17 · usefulness score 36/100

Also tagged “assessment”

840 studies in the library carry the topic tag “assessment”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 840 tagged studies.

• Performance of the Brain Health Test-7, Mini-Mental State Examination, and Montreal Cognitive Assessment for detecting subjects with mild cognitive impairment International Psychogeriatrics · 2025-04-01 · usefulness score 46/100 · Getting a diagnosis
• Development and validation of a predictive nomogram for mild cognitive impairment in middle-aged and elderly populations: A multi-module analysis integrating air quality and sociodemographic factors Journal of Alzheimer s Disease · 2025-10-07 · usefulness score 39/100 · Risk factors
• Digital Clock and Recall is superior to the Mini-Mental State Examination for the detection of mild cognitive impairment and mild dementia Alzheimer's research & therapy · 2024-01-02 · usefulness score 59/100 · Digital health tools

Similar studies

• Montreal Cognitive Assessment (MoCA): validation study for vascular dementia 2012 · Cognitive tests and assessment
• Normative data of the Spanish version of the Montreal Cognitive Assessment (MoCA) in older individuals from Peru 2025 · Getting a diagnosis
• Montreal Cognitive Assessment (MoCA)-Italian version: regression based norms and equivalent scores 2015 · Cognitive tests and assessment
• The Montreal cognitive assessment (MoCA) 8.1 version, including the memory index score (MoCA-MIS): Italian norms 2025 · Getting a diagnosis
• Screening utility of the Montreal Cognitive Assessment (MoCA): in place of--or as well as--the MMSE? 2012 · Cognitive tests and assessment
• The Montreal Cognitive Assessment (MoCA) - a sensitive screening instrument for detecting cognitive impairment in chronic hemodialysis patients 2014 · Cognitive tests and assessment

More on Getting a diagnosis

• A review that covers this ground Montreal Cognitive Assessment (MoCA) Scale: Strengths, Limitations, and Implication for Clinical Practice Iranian Journal of Psychiatry · 2025-12-20 · usefulness score 32/100
• Newest in this subject The Contribution of Routinely Collected Clinical Data to Dementia Identification in Primary Care: A Cross-Sectional Study Research Square · 2026-10-28 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Beyond “Denial”: Understanding and Responding to Help-Refusal in Dementia Preprints.org · 2026-10-26 · Preprint — not yet peer-reviewed · usefulness score 16/100

See all studies in Getting a diagnosis →