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April 9, 2010Stroke481 citations

Underestimation of Cognitive Impairment by Mini-Mental State Examination Versus the Montreal Cognitive Assessment in Patients With Transient Ischemic Attack and Stroke

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SPSarah T. PendleburyFCFiona C. CuthbertsonSWSarah Welch

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Abstract

BACKGROUND AND PURPOSE: The Mini-Mental State Examination (MMSE) is insensitive to mild cognitive impairment and executive function. The more recently developed Montreal Cognitive Assessment (MoCA), an alternative, brief 30-point global cognitive screen, might pick up more cognitive abnormalities in patients with cerebrovascular disease. METHODS: In a population-based study (Oxford Vascular Study) of transient ischemic attack and stroke, the MMSE and MoCA were administered to consecutive patients at 6-month or 5-year follow-up. Accepted cutoffs of MMSE or =27, whereas only 5 patients had MoCA > or =26 and MMSE or =27, MoCA <26 was associated with higher Rankin scores (P=0.0003) and deficits in delayed recall, abstraction, visuospatial/executive function, and sustained attention. CONCLUSIONS: The MoCA picked up substantially more cognitive abnormalities after transient ischemic attack and stroke than the MMSE, demonstrating deficits in executive function, attention, and delayed recall.

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Pendlebury et al. (2010) studied this question.

synapsesocial.com/papers/6a12a3ab19b8e19607351150https://doi.org/10.1161/strokeaha.110.579888
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