Media outlets are obsessed with the "person, woman, man, camera, TV" meme because it’s easy. It’s a punchline. They treat the Montreal Cognitive Assessment (MoCA) as a high-stakes IQ test or a measure of presidential fitness. They’re wrong. They are fundamentally misunderstanding the biology of the brain and the purpose of clinical screening.
If you can pass a MoCA, you aren’t a genius. You just aren't currently suffering from overt dementia. Comparing a screening tool for Alzheimer’s to a measure of leadership capability is like claiming someone is fit to run a marathon because they didn’t trip over their own feet while walking to the fridge. For another look, consider: this related article.
The Low Bar of Clinical Screening
The MoCA was designed by Dr. Ziad Nasreddine in 1996 for one specific reason: to catch Mild Cognitive Impairment (MCI) that the older Mini-Mental State Exam (MMSE) was missing. It is a 30-point test. Scoring a 26 or above is considered "normal."
Think about that. You can get four questions wrong—forget what day it is, fail to name a rhinoceros, or stumble on basic subtraction—and still be "normal." Related reporting regarding this has been provided by Healthline.
The "lazy consensus" among political pundits is that "acing" this test proves mental sharpness. It doesn't. In the world of neuropsychology, we call this the "ceiling effect." The test is so simple for a healthy adult that the results tell us nothing about their upper-level cognitive functions. It measures the basement, not the penthouse.
- Naming an animal: If you can identify a camel, you don't have visual agnosia.
- Drawing a clock: If you can put the hands at 11:10, your executive function isn't totally collapsed.
- Repeating five words: If you can remember "velvet" for five minutes, your short-term memory is functioning at a basic level.
Bragging about passing a MoCA is the equivalent of a professional athlete bragging that they can tie their own shoes. It’s a baseline requirement for existence, not a badge of honor.
The Myth of the "Mental Challenge"
The public discourse surrounding these tests suggests there is some hidden complexity. There isn't. The "challenge" isn't in the difficulty of the questions; it’s in the vulnerability of the brain being tested.
When a politician or a CEO claims they "aced" a cognitive test, they are weaponizing a clinical tool to distract from the reality of aging. The brain is a biological organ, and like any organ, it undergoes structural changes.
$V_{brain} = V_{initial} \times (1 - r)^t$
In this simplified model of brain volume loss, $r$ represents the rate of atrophy. After age 40, the brain shrinks by about 5% per decade. By 70, the rate often accelerates. No one is immune. "Acing" a 10-minute screening does not stop the shrinking of the prefrontal cortex or the thinning of the hippocampus.
We need to stop asking "Could you pass this test?" and start asking "Why are we using a test meant for nursing homes to vet the most powerful people on Earth?"
Intelligence vs. Cognition
People use these terms interchangeably. They shouldn't.
Intelligence is the ability to acquire and apply knowledge and skills. It involves abstract reasoning, complex problem-solving, and nuanced judgment.
Cognition, in the context of the MoCA, refers to the basic mechanics: orientation, attention, and memory.
You can have a functioning "engine" (cognition) but be a terrible "driver" (intelligence/judgment). Conversely, some of the most brilliant minds in history would struggle with a MoCA during the early stages of a neurodegenerative disease, yet still possess more raw intelligence than a healthy average person.
The danger of the MoCA obsession is that it creates a false sense of security. It allows leaders to hide behind a "perfect score" while their actual ability to synthesize complex information, manage stress, and make high-stakes decisions—functions the MoCA cannot and does not measure—withers away.
The Hidden Failure of "Normal" Scores
I have seen families celebrate a score of 27 while their loved one is clearly losing their grip on reality. This is the dark side of the MoCA.
Because the test is so basic, it often misses early-stage executive dysfunction. A patient can remember the five words and name the animals but can no longer manage their finances or understand the consequences of their actions.
This is known as "compensated impairment." High-functioning individuals—doctors, lawyers, politicians—often have a "cognitive reserve." They are so practiced at social interaction and basic logic that they can breeze through a screening while their brain is riddled with amyloid plaques.
By the time someone fails a MoCA, they aren't just "slipping." They are in trouble. Using this test as a benchmark for high-level performance is a categorical error.
The Political Theater of Neuropsychology
The media treats these tests as a "gotcha" moment. If the "other guy" fails, he’s senile. If "our guy" passes, he’s a genius. This is a scientific travesty.
Neuropsychological assessment is a grueling, multi-hour process. It involves tests like the Wisconsin Card Sorting Test for mental flexibility or the Rey-Osterrieth Complex Figure for visuospatial memory.
If you want to know if a leader is fit, you don't give them a 10-minute screener. You put them through an eight-hour battery of tests that pushes their brain to the point of fatigue. You test their ability to ignore distractions, their processing speed under pressure, and their ability to shift between complex tasks.
The MoCA is the "participation trophy" of medical exams. Everyone who isn't clinically ill gets one.
Stop Asking the Wrong Questions
"Could you pass a cognitive test?" is a clickbait question designed to make the reader feel superior or worried. The answer is: Yes, if you are reading this and understanding the words, you can almost certainly pass the MoCA.
The real question we should be asking is: "Why are we settling for such a low bar of transparency regarding the health of our leaders?"
We demand tax returns, we demand physicals, yet we accept a 30-point screening as proof of mental fitness. It’s an insult to the complexity of the human brain and the gravity of the roles these people fill.
The Actionable Truth
If you are worried about your own brain health, or the health of a parent, do not rely on an online version of the MoCA.
- Baseline matters more than a single score. A drop from 30 to 26 is far more concerning than a steady 26.
- Function over form. If you can pass the test but can't follow a recipe or find your car in a parking lot, the test is wrong, not your life.
- Demand better metrics. Stop participating in the circus that equates "not demented" with "highly capable."
The MoCA is a vital tool for neurologists to identify people who need immediate help. It was never intended to be a leaderboard for the "most stable genius."
Every time we celebrate a "perfect score" on a dementia screening, we lower the collective IQ of the electorate. We are cheering for someone who successfully identified a picture of a lion.
Demand a higher standard, or stop pretending the test matters.
