Temporal Evolution of Poststroke Cognitive Impairment Using the Montreal Cognitive Assessment

Abstract

One of these studies compared cognitively impaired stroke patients (MoCA <26) who improved by ≥2 MoCA points, called reverters, to those who did not improve by ≥2 points. Factors associated with reverter status were older age and more severe stroke symptoms at baseline. 17 Determinants ofBackground and Purpose-The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal pattern of overall and domain-specific cognition at 2 and 6 months after stroke using the MoCA and to identify patient groups at risk for cognitive impairment at 6 months after stroke. Methods-Prospective cohort study in which 324 patients were administered the MoCA at 2 and 6 months post stroke.Cognitive impairment was defined as MoCA<26. Differences in cognitive impairment rates between 2 and 6 months post stroke were analyzed in different subgroups. Patients with MoCA score <26 at 2 months, who improved by ≥2 points by 6 months, were defined as reverters. Logistic regression analyses were used to identify determinants of (1) cognitive impairment at 6 months post stroke and (2) reverter status. Results-Between 2 and 6 months post stroke, mean MoCA score improved from 23.7 (3.9) to 24.7 (3.5), P<0.001. Prevalence of cognitive impairment at 2 months was 66.4%, compared with 51.9% at 6 months (P<0.001). More comorbidity and presence of cognitive impairment at 2 months were significant independent predictors of cognitive impairment 6 months post stroke. No significant determinants of reverter status were identified. Conclusions-Although cognitive improvement is seen ≤6 months post stroke, long-term cognitive deficits are prevalent.Identifying patients at risk of cognitive impairment is, therefore, important as well as targeting interventions to this group.

Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

“…They suggested that the MoCA was more accurate in the detection of long-term post-stroke cognitive impairment as compared to other scales such as the Mini-Mental State Evaluation. Moreover, Nijsse et al (2017) detected 66.4 and 51.9% of post-stroke cognitive impairment defined by a MoCA score <26, after 2 months and 6 months, which is in line with the 47% of cognitive impairment reported at 1 year post-stroke in the present study. In addition, Ben Assayag et al (2015) have recently reported that gait performance was a significant risk marker of cognitive decline 2 years after stroke.…”

Cognitive effect of cilostazol in post stroke cognitive impairment: a prospective study

“…This was comparable to the present study, where cognition also improved at 6 months. A study conducted by Britta et al also demonstrated that cognition improved significantly between 2 and 6 months after stroke [17]. Therefore, even a cognitive decline may develop post stroke, a proportion of patients with cognitive impairment improve in a period in which acute changes have stabilized.…”

Cognitive Disorder After Stroke

“…Независимыми факторами риска развития КН являются значительная коморбидность и наличие КН через 2 меся-ца после инсульта. Факторы, которые определяли бы потенциальный регресс ПИКН, выявлены не были [22].…”