One sunny day in October 2016, I failed the Montreal Cognitive Assessment (MoCA). That’s the test pundits are having a field day with because it’s probably the one President Trump recently bragged that he “aced.”
I remember that day vividly. My neurologist and I sat facing each other over a mahogany desk in Menlo Park, Calif. I’d taken the test because of worrisome cognitive symptoms I was experiencing. I failed, she said. At age 34.
She told me in a calm yet concerned tone, with a hint of surprise. Actually, more than a hint.
I’d failed the MoCA mainly because I had struggled with the memory, attention, language, and delayed recall sections.
At the time, I hadn’t yet been diagnosed with the viral illness that was attacking my brain and causing myriad neuromuscular and cognitive symptoms that had begun nearly two years earlier.
A year after I failed the MoCA, a top neuroimmunologist on the East Coast diagnosed me with a neurological virus that caused atrophy and hypometabolism — in short, neurons were dying — on the left side of my brain. As a result, I lost significant function in my right arm and leg, and my ability to think and remember declined. He strongly urged neurological rehabilitation geared toward stroke management, since my symptoms were similar to those that follow a stroke.
Rehab was my only shot at improving, he said, so I went. I spent 2 1/2 years in five types of neurological rehab at two academic medical centers in New York. I attended therapy up to six times a week and never missed a session. From ages 35 to 37, I sat in stroke rehab centers and braved onlookers who clearly wondered why a youngster like me was in the waiting room.
All the while I grappled with a deeply distressing mix of feelings: fear that rehab wouldn’t work, uncertainty that I would regain my complete functional capacity, and profound confusion about what had happened to me.
My rehab worked tremendously, thanks to brilliant specialists and my deep desire to pull out of the hold the virus had on me. Emotionally, I worked to accept that I had lost nearly five years of my life to a virus. That I had gone from a fundraising consultant for nonprofits to a patient with a drastic loss of function. That a young woman with post-graduate degrees had failed a cognitive assessment test designed for people twice her age.
I could not have anticipated the politicization of the MoCA in the 2020 election. I have watched talking heads and cable news anchors laugh as they depict the MoCA in the context of President Trump and his professed perfect score. They mock the section where the testee is asked to name line drawings of three animals. Feign disbelief that anyone without diagnosed dementia can’t draw a clock showing a specific time. Are certain that anyone can name scores of words that start with “f.”
I wasn’t laughing when I failed the test. And I’m not laughing now.
Regardless of one’s political party, the insensitivity of those poking fun at the test, and by extension the people who fail it, is difficult to take.
I understand the media attention. I get that we don’t want a president who requires a cognitive assessment test, or one who feels compelled to boast about his alleged score. But I’m insulted by the unchecked politicization of the MoCA, and I bet others are too.
It’s insulting to those who have to take it. Who fail it, especially those who are young when they fail it. Who don’t have dementia or fit the profile of the kind of person who would fail this easy test. Who don’t find the test easy at all. And who work for years to get better.
I feel deeply for others taking the MoCA today — young or old — who failed after trying as hard as they could. You should, too.
Sabrina Kippur is the founder of Juice and Salt, a company that creates juices tailored for people with common chronic illnesses, food intolerances, and vitamin deficiencies.