The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke
The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke
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DOI：
10.1016/j.jns.2010.08.051
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发表时间：
2010-12-15
影响因子：
4.4
通讯作者：
Chen, Christopher
中科院分区：
文献类型：
--
作者：
Dong, YanHong;Sharma, Vijay Kumar;Chen, Christopher
背景：脑卒中后血管性认知功能障碍（VCI）患者多为无痴呆的血管性认知功能障碍（VCIND）。简易精神状态检查（MMSE）由于对视觉空间和执行功能障碍不敏感而被批评为VCIND的不良筛查测试。蒙特利尔认知评估（莫卡）的目的是更敏感的赤字，因此可能是一个上级筛选工具VCIND.Methods：稳定的患者在14天内，他们的指数中风没有显着的身体残疾，失语症，构音障碍，活动性精神疾病或预先存在的痴呆症是合格的。在知情同意后进行认知和神经功能测量。在57例MMSE评分未受损的患者中，18例（32%）患者的莫卡评分受损。相比之下，41例莫卡评分未受损的患者中仅2例（4.9%）MMSE评分受损。结论：莫卡在急性脑卒中认知功能障碍的筛查中较MMSE更敏感。需要进行纵向研究，以确定莫卡和MMSE评估在卒中后急性期对卒中后3-6个月正式神经心理学评估标准方法定义的认知障碍的预后价值。(C)2010 Elsevier BV保留所有权利。
Background: The majority of patient with post-stroke Vascular Cognitive Impairment (VCI) have Vascular Cognitive Impairment No Dementia (VCIND). The Mini-Mental State Examination (MMSE) has been criticized as a poor screening test for VCIND due to insensitivity to visuospatial and executive function impairments. The Montreal Cognitive Assessment (MoCA) was designed to be more sensitive to such deficits and may therefore be a superior screening instrument for VCIND.Methods: Stable patients within 14 days of their index stroke without significant physical disability, aphasia, dysarthria, active psychiatric illness or pre-existing dementia were eligible. Cognitive and neurological measures were administered after informed consent.Results: 100 patients were recruited. Of the 57 patients with unimpaired MMSE scores, 18(32%) patients had an impaired MoCA score. By comparison, only 2 out of the 41(4.9%) patients with unimpaired MoCA scores had impaired MMSE scores. Moreover, MMSE domain subtest scores could not differentiate between groups of differing screening test results, whilst MoCA domain subtest scores (Visuospatial/Executive Function, Attention and Recall) could.Conclusion: The MoCA is more sensitive than the MMSE in screening for cognitive impairment after acute stroke. Longitudinal studies are required to establish the prognostic value of MoCA and MMSE evaluation in the acute post-stroke period for cognitive impairment as defined by the standard method of formal neuropsychological evaluation 3-6 months after stroke. (C) 2010 Elsevier B.V. All rights reserved.