NDLI: Is the Montreal Cognitive Assessment superior to the Mini-Mental State Examination to detect poststroke cognitive impairment? A study with neuropsychological evaluation.

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Is the Montreal Cognitive Assessment superior to the Mini-Mental State Examination to detect poststroke cognitive impairment? A study with neuropsychological evaluation.

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Is the Montreal Cognitive Assessment superior to the Mini-Mental State Examination to detect poststroke cognitive impairment? A study with neuropsychological evaluation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lamy, Chantal Auribault, Caroline Roussel, Martine Fickl, Andreas Petitnicolas, Gil Godefroy, Olivier Bugnicourt, Jean Marc Canaple, Sandrine
Description	Country affiliation: France Author Affiliation: Godefroy O ( Departement of Neurology, Laboratory of Functional Neurosciences, UniversityHospital of Amiens, Amiens, France. godefroy.olivier@chu-amiens.fr)
Abstract	BACKGROUND AND PURPOSE: A screening test is required to improve the diagnosis of poststroke cognitive impairment. The Montreal Cognitive Assessment (MoCA), a newly designed screening test, has been found to be more sensitive than Mini-Mental State Examination (MMSE), but its clinical value has not been established by means of a comprehensive neuropsychological battery. This study was designed to assess the value of MoCA and MMSE to detect poststroke cognitive impairment determined by a neuropsychological battery. METHODS: Both screening tests and a neuropsychological battery were administered during the acute phase in 95 patients referred for recent infarct or hemorrhage. Raw MMSE and MoCA scores were used with published cutoffs and new cutoff scores for MMSE and MoCA were also computed after adjustment for age and education. RESULTS: Using raw scores, MoCA was more frequently impaired (P=0.0001) than MMSE. MoCA showed good sensitivity (sensitivity, 0.94) but moderate specificity (specificity, 0.42; positive predictive value, 0.77; negative predictive value, 0.76), whereas an inverse profile was observed for MMSE (sensitivity, 0.66; specificity, 0.97; positive predictive value, 0.98; negative predictive value, 0.58). Adjusted scores with new cutoffs (MMSE(adj) ≤24, MoCA(adj) ≤20) provided good sensitivity and very good specificity for both tests (MMSE(adj): sensitivity, 0.7, specificity, 0.97, positive predictive value, 0.98, negative predictive value, 0.61; MoCA(adj): sensitivity, 0.67, specificity, 0.9, positive predictive value, 0.93, negative predictive value, 0.57). On receiver operating characteristic curve analysis, areas under the curve of all scores were >0.88. CONCLUSIONS: The previously reported high sensitivity of MoCA is associated with low specificity. Both screening tests are moderately sensitive to acute poststroke cognitive impairment. This study provides indications for the diagnosis of poststroke cognitive impairment.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	6
Volume Number	42
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2011-06-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Cognition Disorders Diagnosis Etiology Physiopathology Neuropsychological Tests Stroke Complications Mental Status Schedule Roc Curve Reproducibility Of Results Sensitivity And Specificity Research Support, Non-u.s. Gov't Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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