Boston Cognitive Assessment™ (BoCA™)

A self-administered digital cognitive assessment for healthcare providers, researchers, and individuals.

Complete in under 10 minutes, BoCA™ evaluates cognitive performance across eight domains using randomized, non-repeating tasks — minimizing practice effects and supporting longitudinal tracking. It is an online, automatically scored tool used by researchers for serial assessment of global cognition in clinical trials studying Alzheimer’s, COVID fog, anesthesia, and cancer treatment.
For healthcare providers, BoCA™ supports CPT-reimbursable workflows and streamlines cognitive care planning.
Individuals can use BoCA™ at home for convenient, ongoing monitoring to support early detection and cognitive wellness.


Request a Consultation

Validation

BoCA™ has been validated in multiple studies. In one study, participants with cognitive disorders scored significantly lower in both the BoCA™ and Montreal Cognitive Assessment (MoCA) Test for Dementia compared to normal controls. In another study, participants with cognitive disorders scored significantly lower in both the BoCA™ and Telephone Interview for Cognitive Status (TICS) compared to normal controls. Analyses revealed strong correlation between BoCA™ and MoCA (r = 0.85, p < 0.01) and strong correlation with the Telephone Interview for Cognitive Status (r=0.80, p < 0.01). BoCA™ showed strong test-retest reliability of the total BoCA™ score one week after participants’ initial administration (r=0.89, p< 0.001).

1. Vyshedskiy, A., et al. Boston cognitive assessment (BoCA™) — a comprehensive self-administered smartphone- and computer-based at-home test for longitudinal tracking of cognitive performance. BMC Neurol 22, 92 (2022). https://doi.org/10.1186/s12883-022-02620-6

2. Gold, D., et al. "The Boston cognitive assessment: Psychometric foundations of a self-administered measure of global cognition." The Clinical Neuropsychologist (2021): 1-18. https://doi.org/10.1080/13854046.2021.1933190

3. Ferguson, H., et al. “Preliminary Analysis of the Influence of Age and Education on the Boston Cognitive Assessment (BoCA™).” Archives of Clinical Neuropsychology, 37 (6) 2022. https://doi.org/10.1093/arclin/acac060.303

For Researchers

Longitudinal monitoring is essential for testing novel interventions designed to reduce or reverse cognitive aging. BoCA™ is an invaluable tool for long-term cognitive monitoring. BoCA™ is an online instrument which evaluates global cognition through the completion of tasks spanning eight domains commonly included on other familiar screening instruments of global cognition (e.g., wordlist learning and delayed recall, repeating numerical sequences forward and backward, executive functioning, mental arithmetic, visuospatial reasoning, language and orientation). The BoCA™ uses randomly generated, non-repeating stimuli when assessing each domain, thereby enhancing its utility for serial assessment and long-term monitoring of cognitive status.

BoCA™ has the unique advantages of being automatically scored and utilizing random and non-repeating stimuli to reduce the risks of practice effects, which may be especially beneficial for research projects where cognitive tracking is required.

BoCA™ is currently utilized in dozens of clinical trials studying the effect of cognitive intervention, pharmaceutical treatment for Alzheimer’s disease, COVID fog, researching the effect of anesthesia and preoperative treatment, long-term effect of cancer drugs, as well as other interventional studies of Alzheimer’s disease and dementia.

For Healthcare Providers

Many health care providers administering cognitive testing are using the MOCA or MMSE but are not getting paid for their work. BoCA™ provides rapid, mobile cognitive assessments and personalized cognitive care planning that are reimbursable. Clinical practices can use BoCA™ and get reimburses for CPT 96138, CPT 96132, and CPT 99483 for cognitive assessment administration and interpretation. Practices may also consider CPT 96116 as an alternative telehealth CPT code for cognitive testing. The BoCA™ test, combined with a few additional questions, can meet the requirements for CPT 96116.

Many treatable conditions such as sleep disorders, mood problems, heavy metal accumulation, as well as lack of movement and social interactions can affect memory and thinking. Longitudinal monitoring of cognitive health can help clinicians assess if an underlying condition is causing cognitive decline and guide timely therapeutic interventions. Standard cognitive assessments are not suited for monthly cognitive evaluations. First, they ubiquitously rely on trained professionals. While this approach has a high sensitivity and specificity for the detection of dementia, it is time and resource consuming. Second, the number of variations of standard tests is often limited resulting in strong practice effects. BoCA™ be performed at home using randomly-selected non-repeating tasks to minimize practice effects.

For Individuals

Many treatable conditions such as sleep disorders, mood problems, heavy metal accumulation, as well as lack of movement and social interactions can affect memory and thinking. Longitudinal monitoring of cognitive health can help you assess if an underlying condition is causing cognitive decline and guide timely therapeutic interventions.

The Boston Cognitive Assessment (BoCA™) is a self-administered and assisted online test intended for longitudinal cognitive monitoring. BoCA™ uses random never repeating tasks to minimize learning effects.

BoCA™ can be taken at the comfort of your home.

BoCA™ Domains

BoCA™ evaluates eight cognitive domains using randomized, non-repeating tasks to minimize practice effects. The total maximum score is 30. Higher scores indicate better cognitive performance.

The names of 5 animals are announced verbally. After a short pause, 16 buttons appear (5 correct + 11 distractors). The participant must select the 5 announced animals.

Scoring:
- All five animals on the 1st attempt: 2 points
- All five animals on the 2nd attempt: 1 point
- Otherwise: 0 points

Participants hear verbal instructions and respond by selecting the correct image. Tasks increase in complexity across six levels:
  • Training: One modifier (e.g., “select the blue square”)
  • Level 1–2: One and two modifiers (e.g., “large green triangle”)
  • Level 3: Spatial prepositions (e.g., “square on top of the circle”)
  • Level 4–5: Logic-based object relationships (e.g., “If the tiger was eaten by the lion...”) with up to three-object reasoning

Participants are shown a shape and must select the matching shape after rotation. Includes:
  • Training: Easy rotation
  • Level 1–3: Increasing difficulty (moderate to challenging)

Participants see two analog clocks and must calculate the time difference. Includes:
  • Training: Simple differences
  • Levels 1–3: Increasing difficulty with partial-hour differences

Participants hear digits and must click them in forward or reverse order:
  • Training: 4 digits forward
  • Level 1–2: 4–5 digits forward
  • Level 3–4: 3–4 digits backward

Participants perform mental addition and subtraction:
  • Training: Single-digit addition
  • Levels 1–4: Mixed difficulty with single- and two-digit operations (e.g., 7+16, 17+16, 37–16)

Participants select the correct:
  • Month
  • Year
  • Day of the week

Participants are asked to recall and select the five animals named at the beginning of the test. One point is awarded per correctly recalled animal.

Get Started with BoCA™

BoCA™ has transitioned to BellCurveAndMe for personal use, offering a growing variety of assessments and cognitive activities. For commercial or research purposes, visit Boston Cognitive, where you can access additional information and tailored solutions.