Key result
MoCA detects cognitive impairment in ~70% of post-stroke patients vs. 26% with MMSE.
Cross-Sectional (n=50)
BACKGROUND: current literature suggests that two-thirds of patients will have cognitive impairment at 3 months post-stroke. Post-stroke cognitive impairment is associated with impaired function and increased mortality. UK guidelines recommend all patients with stroke have a cognitive assessment within 6 weeks. There is no 'gold standard' cognitive screening tool. The Montreal cognitive assessment (MoCA) is more sensitive than the Mini-Mental State Examination (MMSE) in mild cognitive impairment and for cognitive impairment in the non-acute post-stroke setting and in a Chinese-speaking acute stroke setting. METHODS: a convenience sample of 50 patients, admitted with stroke or transient ischaemic attack (TIA), were screened within 14 days, using the MoCA and the MMSE. RESULTS: the mean MoCA was 21.80 versus a mean MMSE of 26.98; 70% were impaired on the MoCA (cut-off <26) versus 26% on MMSE (cut-off <27). The MoCA could be completed in <10 min in 90% of cases. CONCLUSION: the MoCA is easy and quick to use in the acute stroke setting. Further work is required to determine whether a low score on the MoCA in the acute stroke setting will predict the cognitive and functional status and to explore what the best cut-off should be in an acute post-stroke setting.
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Blackburn et al. (2012) conducted a cross-sectional in Acute stroke or transient ischaemic attack (TIA) (n=50). Montreal Cognitive Assessment (MoCA) vs. Mini-Mental State Examination (MMSE) was evaluated on Detection of cognitive impairment (MoCA cut-off <26 vs MMSE cut-off <27). The Montreal Cognitive Assessment identified cognitive impairment in 70% of acute stroke or TIA patients compared to 26% with the Mini-Mental State Examination, taking <10 min in 90% of cases.
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