Montreal Cognitive Assessment Predicts Outcomes After Stroke
Brief screening tool is feasible in the setting of acute stroke
FRIDAY, Oct. 19, 2018 (HealthDay News) -- The Montreal Cognitive Assessment (MoCA) administered within seven days after stroke can predict long-term cognitive and functional outcome and mortality, according to a study published online Oct. 17 in Neurology.
Vera Zietemann, Ph.D., from Ludwig-Maximilians University in Munich, and colleagues administered MoCA to 274 patients from two prospective hospital-based cohort studies in Germany (125 participants) and France (149 participants). At six, 12, and 36 months after stroke, cognitive and functional outcomes, and all-cause mortality were assessed.
In pooled analyses, the researchers found that across the three-year follow-up, baseline MoCA score <26 correlated with cognitive impairment defined by neuropsychological testing (odds ratio, 5.30) and by Clinical Dementia Rating scale score ≥0.5 (odds ratio, 2.53); functional impairment defined by modified Rankin Scale score >2 (odds ratio, 5.03) and by Instrumental Activities of Daily Living score <8 (odds ratio, 2.48); and with mortality (hazard ratio, 7.24). Across all prespecified cognitive domains (executive function/attention, memory, language, visuospatial ability), worse performance was seen for patients with MoCA score <26. The area under the curve for prediction of cognitive impairment and functional impairment was increased with MoCA.
"Given the brevity of the test and its feasibility in the setting of acute stroke, our findings support the use of the MoCA as a routine clinical tool to identify high-risk patients who might benefit from close monitoring," the authors write.