The Montreal cognitive assessment is superior to national institute of neurological disease and stroke-Canadian stroke network 5-minute protocol in predicting vascular cognitive impairment at 1 year. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Dong, YanHong; Xu, Jing; Chan, Bernard; Seet, Raymond; Venketasubramanian, Narayanaswamy; Teoh, Hock; Sharma, Vijay; Chen, Christopher
• Is Part Of: BMC neurology. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 6
• Publication Date: 2016-12
• Subjects: Vascular dementia -- Acute stroke -- Predictive value of tests -- Cognition; Neurology -- Periodicals; 616.8005
• DOI: 10.1186/s12883-016-0570-y
• Languages: English
• ISSNs: 1471-2377

Abstract

Abstract Background The predictive ability of National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol and Montreal Cognitive Assessment (MoCA) administered sub-acutely and at the convalescent phase after stroke for significant vascular cognitive impairment (VCI) at 1 year is unknown. We compared prognostic values of these tests. Methods Patients with ischemic stroke and transient ischemic attack (TIA) received MoCA sub-acutely (within 2 weeks) and 3–6 months after stroke followed by a formal neuropsychological evaluation at 1 year. The total score of NINDS-CSN 5-minutes protocol was derived from MoCA. Moderate-severe VCI was defined as neuropsychological impairment in ≥ 3 domains. Area under the receiver operating characteristic curve (AUC) analyses were conducted to establish the optimal cutoff points and discriminatory properties of the MoCA and NINDS-CSN 5-minute protocol in detecting moderate-severe VCI. Results Four hundre patients were recruited at baseline. Of these, 291 received a formal neuropsychological assessment 1 year after stroke. 19 % patients had moderate-severe VCI. The MoCA was superior to the NINDS-CSN 5-minute protocol [sub-acute AUCs: 0.89 vs 0.80, p < 0.01; 3–6 months AUCs: 0.90 vs 0.83, p < 0.01] in predicting for moderate-severe VCI at 1 year. At respective cutoff points, MoCA had significantly higher sensitivity than the NINDS-CSN 5-minute protocol at baseline (p = 0.01) and 3–6 months (p = 0.04). Conclusions MoCA administered sub-acutely and 3–6 months after stroke is superior to the NINDS-CSN 5-minute protocol in predicting moderate-severe VCI at 1 year.