Draft:Boston Cognitive Assessment

  • Comment: There is still AI text in this, particularly in the second half of the article. The second half is also unsourced.
    Can the submitting editor kindly confirm whether WP:COI applies? And whether a paid COI applies? ChrysGalley (talk) 21:09, 12 March 2026 (UTC)

The Boston Cognitive Assessment (BoCA) is a widely used screening assessment for detecting cognitive impairment and tracking cognitive performance over time.[1] It is used by healthcare providers, researchers, and individuals for cognitive screening, monitoring longitudinal cognitive change, and supporting clinical and research workflows.

Overview

BoCA is an online cognitive test that can typically be completed in under 10 minutes and is automatically scored. The assessment evaluates performance in eight cognitive domains and uses randomized, non-repeating tasks to reduce practice effects, which enhances its suitability for repeated testing over time. BOCA can be administered on a smartphone or a desktop computer. It does not require a clinician to be physically present during administration. BoCA can be used for early detection of cognitive change in areas such as Alzheimer's disease, postoperative cognitive effects, cancer treatment-related cognitive impairment, COVID fog, and in many other applications requiring an evaluation of cognition.

Format

BoCA assesses eight cognitive domains:

  1. Memory–Immediate recall: The names of 5 animals are announced verbally. After a short pause, 16 buttons are displayed indicating the names of the 5 announced animals and 11 other random animals. The participant is expected to select the 5 announced animals. This subtest includes three attempts scored as follows: all five animals selected correctly on the 1st attempt: 2 points; all five animals selected correctly on the 2nd attempt: 1 point; otherwise, zero points.
  2. Language–Sentence comprehension: Evaluated across 5 levels of gradually increasing complexity (max = 5 points).
  3. Visuospatial Reasoning–Mental rotation: Evaluated across 3 levels of gradually increasing complexity (max = 3 points).
  4. Executive function – Clock Test: Evaluated across 3 levels of gradually increasing complexity (max = 4 points).
  5. Attention – Sustained and selective attention tasks. Evaluated across 4 levels of gradually increasing complexity (max = 4 points).
  6. Mental math – Arithmetic reasoning and calculation. Evaluated across 3 levels of gradually increasing complexity (max = 4 points).
  7. Orientation – Temporal orientation (max = 3 points).
  8. Recall – Delayed retrieval of previously learned 5 animals (max - 5 points; one point awarded for each correctly identified animal).[1]

The maximum total score is 30, with higher scores indicating better cognitive performance.

Validation and research

BoCA has been validated in multiple peer-reviewed studies that established its reliability and clinical utility.[1][2][3][4][5][6] Additional studies have evaluated BoCA in different countries and various environments, including its use in primary care, neurology, and rehabilitation settings.[3][4][5][6]

Clinical and research use

BoCA is used in clinical environments to help with cognitive screening and ongoing monitoring of patients, including remote administration when needed. It has been also incorporated into multiple research studies and clinical trials requiring longitudinal tracking of global cognition. The test is designed to integrate with clinical workflows and supports longitudinal tracking, reporting features, and age- and sex-adjusted scoring.

Since the BOCA assesses multiple cognitive domains, it can be a useful cognitive screening tool for several neurological diseases that affect younger populations, such as Parkinson's disease, vascular cognitive impairment, Huntington's disease, sleep disorder, brain tumors, multiple sclerosis and other conditions such as traumatic brain injury, cognitive impairment from schizophrenia and heart failure.

Nonverbal and minimally verbal individuals

BOCA does not require expressive language responses, allowing cognition to be evaluated without dependence on speech. As a result, BOCA has been popular in nonverbal and minimally verbal individuals, including people with aphasia, ASD, apraxia, and other communication disorders.

See also

References

  1. ^ a b c Vyshedskiy, Andrey; Netson, Rebecca; Fridberg, Elisabeth; Jagadeesan, Priyanka; Arnold, Matthew; Barnett, Sophie; Gondalia, Anjali; Maslova, Victoria; de Torres, Lauren; Ostrovsky, Simone; Durakovic, Danijel; Savchenko, Andrei; McNett, Sienna; Kogan, Mikhail; Piryatinsky, Irene; Gold, Dov (December 2022). "Boston cognitive assessment (BOCA) — a comprehensive self-administered smartphone- and computer-based at-home test for longitudinal tracking of cognitive performance". BMC Neurology. 22 (1). doi:10.1186/s12883-022-02620-6. This article incorporates text from this source, which is available under the CC BY 4.0 license.
  2. ^ Padovani, Alessandro; Caratozzolo, Salvatore; Galli, Alice; Crosani, Luca; Zampini, Silvio; Cosseddu, Maura; Turrone, Rosanna; Zancanaro, Andrea; Gumina, Bianca; Vicini-Chilovi, Barbara; Benussi, Alberto; Vyshedskiy, Andrey; Pilotto, Andrea (February 2025). "Validation and convergent validity of the Boston cognitive assessment (BOCA) in an Italian population: a comparative study with the Montreal cognitive assessment (MoCA) in Alzheimer's disease spectrum". Neurological Sciences. 46 (2): 697–704. doi:10.1007/s10072-024-07775-3.
  3. ^ a b Thompson, Louisa I.; Lawrence, Molly; Rosenbaum, Jennifer A; Czech, Stephanie; Anthony, David C; Chandran, Rabin F; Goldberg, Arnold R; Vyshedskiy, Andrey; Elwy, Anashua R; Eaton, Charles B (December 2024). "Feasibility and Acceptability of Digital Cognitive Screening Approaches for Older Adults in Primary Care". Alzheimer's & Dementia. 20 (S10). doi:10.1002/alz.094344.
  4. ^ a b Gold, Dov; Stockwood, Jennifer; Boulos, Kirolos; Kasha, Sabrina; Vyshedskiy, Andrey; deTorres, Lauren; Ostrovsky, Simone; Durakovic, Danijel; Savchenko, Andrei; Piryatinsky, Irene (17 November 2022). "The Boston cognitive assessment: Psychometric foundations of a self-administered measure of global cognition". The Clinical Neuropsychologist. 36 (8): 2313–2330. doi:10.1080/13854046.2021.1933190.
  5. ^ a b Wertheimer, Jeffrey; Gottuso, Ann; Wertheimer, Mia; Gold, Dov (April 2025). "Psychometric Properties and Clinical Utility of the Boston Cognitive Assessment (BOCA) on an Acute Rehabilitation Unit". Archives of Physical Medicine and Rehabilitation. 106 (4): e32. doi:10.1016/j.apmr.2025.01.082.
  6. ^ a b Yin, Xiao; Zhu, Haiying; Ji, Panpan; Wu, Beixuan; Zhang, Yi (28 November 2025). "Significance of the Boston Cognitive Assessment in patients with chronic post-stroke cognitive impairment". Frontiers in Neurology. 16. doi:10.3389/fneur.2025.1690494.
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