Cognitive Domains Reference: MoCA and SLUMS Mapping

What it covers

This reference organizes cognition into seven domains arranged as a bottom-up hierarchy, following Harvey PD (Dialogues Clin Neurosci. 2019;21(3):227–237): 1 sensation and perception, 2 motor skills and construction, 3 attention and concentration, 4 memory, 5 language and verbal skills, 6 processing speed, and 7 executive functioning. Executive functioning sits at the top because it depends on every domain below it, which is why impairments rarely occur in isolation. For each domain the page gives a definition, its subdomains, the MoCA and SLUMS tasks that sample it with their point values, and the conditions in which it is typically impaired, such as schizophrenia, ADHD, depression, Alzheimer disease, frontostriatal conditions, TBI and right parietal stroke.

MoCA vs SLUMS domain coverage

Both screens are scored out of 30, but they sample domains differently. A comparison table lists the tasks and primary-domain points for each test:

Domain	MoCA points	SLUMS points
Executive	9	15*
Processing speed	1	3
Language	6	3
Memory	13	18
Attention	4	5*
Motor / construction	4	6
Sensation / perception	Not directly assessed by either screen

*Domain points overlap. Many tasks, such as clock drawing, engage several domains at once, and point values reflect the primary domain only.

Score interpretation

MoCA: add 1 point for 12 or fewer years of formal education (maximum 30). The conventional cut-off is 26 or more for normal cognition. The page lists commonly used impairment bands (18–25, 10–17, below 10) and labels them as not validated. It notes sensitivity of about 90% and specificity of about 87% for MCI (Nasreddine et al., 2005), and that a cut-off of 23 improved accuracy in a meta-analysis (Carson et al., 2018).

SLUMS: cut-offs depend on education. With a high school education: 27–30 normal, 21–26 mild neurocognitive disorder, 1–20 dementia. With less than a high school education: 25–30 normal, 20–24 mild neurocognitive disorder, 1–19 dementia (Tariq SH, et al. Am J Geriatr Psychiatry. 2006).

Who it is for

The page is a teaching and bedside reference for residents, students and clinicians who give cognitive screens and want to know what a lost point actually tests. It links to the site's Clock-Drawing Test chapter. Screening scores are one input among many; diagnosis needs history, collateral information and medical workup.