The most established and widely used screening tool to detect
CI worldwide is the Mini Mental State Examination (MMSE) [8],
however this instrument has no items assessing executive functioning.
A growing body of research has demonstrated its limitations in the
identification of CI in multiple clinical populations e.g. multiple
sclerosis, cancer, Parkinson’s disease, dementia [9] and alcoholdependence
[10]. The Montreal Cognitive Assessment (MoCA) is an
alternative screening tool for CI, published over a decade ago, and was
designed to detect mild-to-moderate impairment. It contains items
assessing executive functioning and has excellent sensitivity and
good specificity [11], yet is rarely applied in substance use settings or
used in research. Evidence of its superiority over the MMSE has been
demonstrated with a range of clinical populations [12-16].