After the announcement that President Donald Trump underwent the Montreal Cognitive Assessment (MoCA), media coverage and public interest in the test spiked drastically, according to a research letter published in JAMA Neurology.

Several studies have found a learning effect among people who undergo repetitive longitudinal testing. These results then indicate the potential for the efficacy of the MoCA to be compromised for people exposed to it via media coverage.

The past few months have seen the president’s cognitive fitness become a hot-button topic among both the general public and the medical community.

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It has become typical for presidents of the United States to undergo routine yearly medical assessments while in office. Although he was elected in 2016, Trump’s first assessment was completed in January 2018. During a briefing after Trump’s assessment, the physician to the president, Rear Admiral Ronny Jackson, MD, announced that that Trump had undergone the MoCA, making Trump the first president of the United States to undergo formal cognitive evaluation while in office.

Hourmazd Haghbayan, MD, of the department of medicine at the University of Toronto, and colleagues, systematically searched for online news articles using the keywords “Montreal Cognitive Assessment” in Google News that were published between January 15 and January 21, 2018. They then narrowed their article pool by eliminating any articles that did not discuss the MoCA in association with Trump.

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Overall, the researchers found 190 unique articles that fit their criteria. Of these, 53.7% included all or part of the MoCA; 44.2% included the MoCA in its entirety via hyperlink (35.3%) or embedded in the article (17.4%). Among articles that included the MoCA, 8.9% included the answer key and 17.4% invited readers to self-administer the test.

Additionally, the researchers noted that Google Trends showed a substantial uptick in searches for MoCA after Dr Jackson’s announcement.

Dr Haghbayan and colleagues stressed the need for further research to determine if test performance is affected in an exposed population. Until then, they advise caution.

“Clinicians assessing patients with the MoCA should be aware of this potential exposure to the test and should therefore consider routinely inquiring whether a patient has previously been exposed to the MoCA,” the researchers concluded.


Haghbayan H, Coomes EA, Cheema AN, et al. Media dissemination of the Montreal Cognitive Assessment after President Donald Trump’s Medical Evaluation. [published online July 16, 2018]. JAMA Neurol. doi:10.1001/jamaneurol.2018.1777