MoCA Talk #23:
From JAMA to GUIDE: A 20-Year Journey Advancing Dementia Care (Malaz Boustani, MD, MPH) - Thu, June 5, 2025, 12:00 PM EDT
The MoCA XpressO is brief cognitive self-administered cognitive screening tool designed to be predictive of MoCA performance.
Purpose: It is intended for the general population, particularly adults and older adults who have concerns about their memory. It enables individuals to self-assess and determine whether they should consult a healthcare professional for further cognitive evaluation.
Administration time
Approximately 5 minutes.
Setting
The XpressO may be self-administered in either the examinee’s home or a clinical setting.
Form
Digital application compatible with smartphone, tablet, or desktop computer. Available for both Apple (iOS) and Android devices. The MoCA XpressO is composed of user-friendly tasks, mainly involving drag-and-drop interactions. These tasks differ from those included in the standard MoCA, which is intended for administration by healthcare professionals.
Cost
Freely available for clinical and educational use; a license is required for commercial use.
Upon completion of all MoCA XpressO tasks, a report is generated that provides a score reflecting both speed and accuracy, indicating whether performance falls within the expected range. The report also includes a recommendation to either continue monitoring performance by repeating the test or to consult a healthcare professional for further evaluation.
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| Property | Summary of Findings Across Studies | Typical Values / Ranges | Interpretation |
|---|---|---|---|
Alignment with Standard MoCA | XpressO performance predicts if individual will fall above or below MoCA cut-of | AUC ≈ 0.85 | XpressO distinguishes individuals with normal or below normal MoCA scores |
Sensitivity | At the upper cut-off (72), the tool correctly identifies most individuals with potential cognitive impairment, according to MoCA cut-off | Sensitivity ≈ 91% | High likelihood of detecting individuals who may require follow-up. |
Specificity | At the lower cut-off (42), the tool correctly identifies most individuals without cognitive impairment, according to MoCA cut-off | Specificity ≈ 90% | Reduces unnecessary referrals for those unlikely to have impairment. |
Intermediate Scores | Results between the upper and lower cut-offs are indeterminate. | Scores 42–72 | Require clinical judgment and may prompt further evaluation if concerns persist. XpressO can be repeated. |