What’s the Montreal Cognitive Assessment mental test Trump took?

Can you recognize a lion? How about remembering a list of five words, right away and five minutes later?

President Donald Trump can. He got all the usual tests as part of his annual physical exam as president. But he also added an extra exam — a cognitive screening test for memory loss or early dementia.

It’s not part of the usual battery of tests given to a president and may reflect an outpouring of coverage and commentary questioning whether Trump is mentally fit for office.

Trump insisted on taking the test and passed it with flying colors, Admiral Dr. Ronny Jackson, presidential physician, told reporters.

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Trump leaves Walter Reed National Military Medical Center after annual physical
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Trump leaves Walter Reed National Military Medical Center after annual physical
US President Donald Trump shakes hands with White House Physician Rear Admiral Dr. Ronny Jackson, following his annual physical at Walter Reed National Military Medical Center in Bethesda, Maryland, January 12, 2018. / AFP PHOTO / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
U.S. President Donald Trump waves from the steps of Marine One helicopter upon his departure after his annual physical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, U.S., January 12, 2018. REUTERS/Yuri Gripas
U.S. President Donald Trump shakes hands with Dr. Ronny Jackson after his annual physical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, U.S., January 12, 2018. REUTERS/Yuri Gripas
U.S. President Donald Trump waves from the steps of Marine One helicopter upon his departure after his annual physical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, U.S., January 12, 2018. REUTERS/Yuri Gripas
U.S. President Donald Trump shakes hands with Dr. Ronny Jackson after his annual physical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, U.S., January 12, 2018. REUTERS/Yuri Gripas
U.S. President Donald Trump boards the Marine One helicopter upon his departure after his annual physical exam at Walter Reed National Military Medical Center in Bethesda, Maryland, U.S., January 12, 2018. REUTERS/Yuri Gripas
U.S. President Donald Trump waves to members of the media following his first medical exam at Walter Reed National Military Medical Center in Besthesda, Maryland, U.S., on Friday, Jan. 12, 2018. Trump�is predicting that his first physical since taking office will show he is in good health as the White House moves to stamp out fresh questions about whether the 71-year-old is mentally fit for office. Photographer: Chip Somodevilla/Pool via Bloomberg
Ronny Jackson, physician for U.S. President Donald Trump, gives a thumbs following the president's first medical exam at Walter Reed National Military Medical Center in Besthesda, Maryland, U.S., on Friday, Jan. 12, 2018. Trump�is predicting that his first physical since taking office will show he is in good health as the White House moves to stamp out fresh questions about whether the 71-year-old is mentally fit for office. Photographer: Chip Somodevilla/Pool via Bloomberg
U.S. President Donald Trump waves to members of the media before boarding Marine One following his first medical exam at Walter Reed National Military Medical Center in Besthesda, Maryland, U.S., on Friday, Jan. 12, 2018. Trump�is predicting that his first physical since taking office will show he is in good health as the White House moves to stamp out fresh questions about whether the 71-year-old is mentally fit for office. Photographer: Chip Somodevilla/Pool via Bloomberg
BETHESDA, MD - JANUARY 12: (AFP OUT) U.S. President Donald Trump salutes before boarding Marine One on departure from Walter Reed National Military Medical Center following his annual physical examination January 12, 2018 in Bethesda, Maryland. Trump will next travel to Florida to spend the Dr. Martin Luther King Jr. Day holiday weekend at his Mar-a-Lago resort. (Photo by Chip Somodevilla/Getty Images)
BETHESDA, MD - JANUARY 12: (AFP OUT) U.S. President Donald Trump waves to journalists as he boards Marine One on departure from Walter Reed National Military Medical Center following his annual physical examination January 12, 2018 in Bethesda, Maryland. Trump will next travel to Florida to spend the Dr. Martin Luther King Jr. Day holiday weekend at his Mar-a-Lago resort. (Photo by Chip Somodevilla/Getty Images)
US President Donald Trump shakes hands with White House Physician Rear Admiral Dr. Ronny Jackson, following his annual physical at Walter Reed National Military Medical Center in Bethesda, Maryland, January 12, 2018. / AFP PHOTO / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
BETHESDA, MD - JANUARY 12: Protesters gather outside Walter Reed National Military Medical Center as U.S. President Donald Trump arrives his annual physical examination January 12, 2018 in Bethesda, Maryland. Trump will next travel to Florida to spend the Dr. Martin Luther King Jr. Day holiday weekend at his Mar-a-Lago resort. (Photo by Chip Somodevilla/Getty Images)
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“Many of you may have picked up on the fact that we did do a cognitive assessment,” Jackson said.

“I didn’t feel it was clinically indicated,” he added. “It has been my experience that the president is very sharp and he’s very articulate when he speaks to me.”

Related: Trump insists he is a stable genius

Trump is the first president to undergo the memory screening, Jackson said. The White House medical team chose the Montreal Cognitive Assessment (MoCA), which was designed as a rapid screening tool for mild cognitive dysfunction — a loss of memory and clear thinking ability that sometimes precedes dementia.

The 30-point test includes drawings of a lion and a rhinoceros, which patients must name. Test-takers are also asked to copy a simple line sketch of a cube; match the letter A to the number 1, the letter B to the number 2 and so on. They are asked to recall a list of five words and repeat very short lists of numbers forward and backwards.

It tests attention, memory and visual skills, all of which deteriorate in people with mild cognitive impairment (MCI) or dementia. A score of 26 or lower indicates dementia.

Cochrane Collaboration review of the test showed it detects 94 percent of people with dementia.

It’s one of several quick tests that can screen people for MCI or dementia.

“We picked one of the ones that was a little longer, a little more involved,” Jackson said.

“It was a more difficult one of all of them. It took significantly longer to complete, and the president did extremely well on it,” Jackson said.

Related: Trump isn't mentally ill, expert who wrote the nook on mental illness says

“If he had some type of mental, cognitive issue … this test is sensitive enough. It would pick up on it. He would not have gotten 30 out of 30 on the test. So I’m very confident at this particular stage that he has nothing like that going on.”

Alzheimer’s patients often have trouble drawing or naming objects, and the test can quickly indicate problems with short-term memory. Spatial skills also deteriorate with MCI and dementia, as does attention.

Trump took the test during the annual physical that is customary for presidents at the Walter Reed National Military Medical Center in Maryland on Friday.

Related: Trump's Falsehoods are Classic Gaslighting, Experts Say

Jackson, who is the official physician to the president, said he did not see anything unusual — especially not for a 71-year-old American.

Because Trump has blustered about his health before, there had been suspicions among some critics that the White House might conceal evidence that he is mentally or physically unfit for office.

Jackson, who also served as former president Barack Obama’s official physician, denied anything has been hidden.

“I can promise you there is absolutely nothing that I’m withholding from this,” Jackson said.

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