Use of the Montreal Cognitive Assessment in Evaluations of Adjudicative Competency

This archival study explored the impact of performance on the Montreal Cognitive Assessment (MoCA), a brief cognitive screen performed as part of a mental status examination (MSE), on adjudicative competency opinions provided for 194 criminal defendants, in examinations that did not include a competency-specific instrument. The MoCA’s suggested cutoff of 26 as indicative of “mild cognitive impairment” was not determinative of examiners’ conclusions regarding competency-related capacities. However, when scores were considered dimensionally, MoCA performance during the MSE accounted for additional significant variance in examiners’ competency opinions, when added to a logistic regression model containing age and presence of psychotic symptoms.