Background/Aims: To evaluate the psychometric properties of the Hong Kong Montreal Cognitive Assessment (HK-MoCA) in patients with cerebral small vessel disease (SVD). Methods: 40 SVD patients and 40 matched controls were recruited. Concurrent and criterion validity, inter-rater and test-retest reliability, internal consistency of the HK-MoCA were examined and clinical observations were made. Results: Performance on the HK-MoCA was significantly predicted by both executive (β = 0.23, p = 0.013) and non-executive (β = 0.64, p < 0.001) composite scores. It differentiated SVD patients from controls (area under the curve = 0.81, p < 0.001) with an optimal cutoff at 21/22. Reliability, internal consistency and clinical utility were good. Conclusion: The HK-MoCA is a useful cognitive screening instrument for use in SVD patients.

Background and Purpose The NINDS-CSN vascular cognitive impairment (VCI) Harmonization working group proposed a brief cognitive protocol for screening of VCI. We investigated the validity, reliability and feasibility of the Montreal Cognitive Assessment 5-minute protocol (MoCA 5-min protocol) administered over the telephone. Methods Four items examining attention, verbal learning and memory, executive functions/language and orientation were extracted from the MoCA to form the MoCA 5-min protocol. One hundred and four patients with stroke or TIA, including 53 with normal cognition (CDR 0) and 51 with cognitive impairment (CDR 0.5 or 1), were administered the MoCA in clinic and a month later, the MoCA 5-min protocol over the telephone. Results Administration of the MoCA 5-min protocol took five minutes over the telephone. Total score of the MoCA 5-min protocol correlated negatively with age (r=-0.36, p<0.001) and positively with years of education (r=0.41, p<0.001) but not with gender (rho=0.03, p=0.773). Total scores of the MoCA and MoCA 5-min protocol were highly correlated (r=0.87, p<0.001). The MoCA 5-min protocol performed equally well as the MoCA in differentiating patients with cognitive impairment from those without (AUC for MoCA 5-min protocol=0.78; MoCA=0.74, p>0.05 for difference; Cohen's d for group difference 0.801.13). It differentiated cognitively impaired patients with executive domain impairment from those without (AUC=0.89, p<0.001; Cohen's d=1.7 for group difference). 30-day test-retest reliability was excellent (Intraclass correlation coefficient=0.89). Conclusions The MoCA 5-min protocol is a free, valid and reliable cognitive screen for stroke and TIA. It is brief and highly feasible for telephone administration.