Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke

被引:173
作者
Cumming, T. B. [1 ]
Churilov, L. [1 ]
Linden, T. [1 ,2 ]
Bernhardt, J. [1 ]
机构
[1] Florey Inst Neurosci & Mental Hlth, Stroke Div, Melbourne, Vic, Australia
[2] Gothenburg Univ, Ctr Brain Res & Rehabil, Gothenburg, Sweden
来源
ACTA NEUROLOGICA SCANDINAVICA | 2013年 / 128卷 / 02期
关键词
cerebrovascular disease; cognitive impairment; neuropsychology; stroke; IMPAIRMENT HARMONIZATION STANDARDS; NEUROLOGICAL DISORDERS; NATIONAL INSTITUTE; CANADIAN STROKE; SUBACUTE STROKE; 1ST-EVER STROKE; ASSESSMENT MOCA; DEMENTIA; PREDICTORS; SUPERIOR;
D O I
10.1111/ane.12084
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective - To determine the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) as screening tools for cognitive impairment after stroke. Materials and methods - Cognitive assessments were administered over 2 sessions (1 week apart) at 3 months post-stroke. Scores on the MoCA and MMSE were evaluated against a diagnosis of cognitive impairment derived from a comprehensive neuropsychological battery (the criterion standard). Results - Sixty patients participated in the study [mean age 72.1 years (SD = 13.9), mean education 10.5 years (SD = 3.9), median acute NIHSS score 5 (IQR 3-7)]. The MoCA yielded lower scores (median = 21, IQR = 17-24; mean = 20.0, SD = 5.4) than the MMSE (median = 26, IQR = 22-27; mean = 24.2, SD = 4.5). MMSE data were more skewed towards ceiling than MoCA data (skewness = -1.09 vs -0.73). Area under the receiver operator curve was higher for MoCA than for MMSE (0.87 vs 0.84), although this difference was not significant (chi(2) = 0.48, P = 0.49). At their optimal cut-offs, the MoCA had better sensitivity than the MMSE (0.92 vs 0.82) but poorer specificity (0.67 vs 0.76). Conclusions - The MoCA is a valid screening tool for post-stroke cognitive impairment; it is more sensitive but less specific than the MMSE. Contrary to the prevailing view, the MMSE also exhibited acceptable validity in this setting.
引用
收藏
页码:122 / 129
页数:8
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