The test accuracy of the montreal cognitive assessment (MoCA) in stroke

Chan, Edgar; Altendorff, Samantha; Oliver, Richard; Gill, Sascha; Healy, Colm; Werring, David J.; Cipolotti, Lisa

doi:10.1016/j.jns.2017.08.3356

Cited by 5 publications

(6 citation statements)

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“…We found discharge destination to be associated with numerous variables at the univariable level: Berg balance score, indicating risk of falling (recently shown by Louie and Eng 21 as a strong predictor of regaining unassisted ambulation), age (as shown previously by Scrutinio et al, Glader et al, and Bindawas et al), 3,18,22 FIM score and improvement in FIM score during the stay on rehabilitation (as shown by Scrutinio et al and Thorpe et al), 3,23 bladder and bowel incontinence (bladder incontinence was also shown to be related to LTC discharge by John et al), 15 ability to transfer (not previously explored), and MoCA score (as shown by Chan et al). 24 The self-perceived functional improvement, dependency for indoor functioning and social relations with family members/caregivers are also determinants in participation and eventual autonomy, 25 but this was not examined in our study.…”

Section: Discussionmentioning

confidence: 82%

Discharge Destination from a Rehabilitation Unit After Acute Ischemic Stroke

Saab

Glass-Kaastra

Young

2019

Can. J. Neurol. Sci.

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ABSTRACT:Background: We reviewed numerous variables for ischemic stroke patients admitted to a rehabilitation unit to determine those that were statistically associated with discharge destination. Methods: A retrospective chart review of patients with ischemic stroke discharged from the rehabilitation unit between January 1, 2005 and December 31, 2015. Variables were examined for their association with discharge destination (home versus long-term care (LTC)). Univariable relationships with discharge destination were assessed, and a multivariable logistic regression model was built. Results: Univariate predictors of discharge to LTC: advanced age, decreasing admission and discharge functional independence measure (FIM) scores, increasing change in FIM score from admission to discharge, dependency, residence outside of home before the stroke, absence of a caregiver, urinary and bowel incontinence, low Berg balance score at admission and discharge, low Montreal Cognitive Assessment scores, smoking, chronic heart failure, and an inability to transfer. Multivariable logistic regression: five factors remained significant predictors with LTC disposition: advanced age, bowel incontinence, residence outside of the home prior to stroke, right hemisphere site of the stroke, and absence of a caregiver. Conclusions: Several easily measured variables were significantly associated with discharge to LTC versus home following stroke rehabilitation.

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Section: Discussionmentioning

confidence: 82%

Discharge Destination from a Rehabilitation Unit After Acute Ischemic Stroke

Saab

Glass-Kaastra

Young

2019

Can. J. Neurol. Sci.

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“…The high number percentage somehow comparable with study done by Lestari et al in Jakarta, that found 72.41 % of the post stroke sample subject has cognitive problems regarding other confounding factor such as ischemic stroke risk factor dan ethnic biodiversity of the subjects between these studies. 2,11 This is considered as a weakness of this study that did not elaborate as per domain score. Another confounding factor also found on undocumented risk factor of the subject, as any vascular compromise could also become bias in cognitive performance.…”

Section: Discussionmentioning

confidence: 96%

Cognitive Function Differences based on Hemispheric Lesions of First-Ever Ischemic Stroke Patients

Nasution

Lubis

Erwin

et al. 2018

ijmsci

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Ischemic stroke is one of stroke subtype often correlated with disturbance of cognitive function. We conduct an observational study with cross-sectional design of 70 ischemic stroke patients. Objective of this study is to evaluate cognitive differences based on hemispheric lateralization lesions. We used Montreal Cognitive Assessment -Indonesian version (MoCA-Ina) to assess cognitive function resulting on 70 patients, consist of 48 subjects (68.57 %) of left hemispheric stroke and 22 subjects (31.43%) of right hemispheric stroke. As much as 68 subjects (97.14 %) are categorized as having cognitive disturbance. Mean differences of MoCA-Ina was assessed using Mann-Whitney test resulting no significant differences between left vs right hemisphere groups (18.94 + 3.26 vs 19.82 + 3.13; p= 0.320). Further study would warrant lesions lateralizations could affects cognitive performance of ischemic stroke patients.

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“…The primary aim of the study was to investigate the usefulness of adding QS screening items to the MoCA to detect cognitive impairment after stroke, particularly in speed of processing, non-verbal memory and executive functioning [15]. We showed that a high proportion of patients (74%) who were classified as cognitively "intact" on the MOCA failed in at least one of the three QS screening domains.…”

Section: Discussionmentioning

confidence: 99%

“…We conducted two recent studies to examine the accuracy of the MoCA compared with comprehensive neuropsychological assessment in a cohort of patients with recent stroke. The first study with 136 patients showed that of the 22% of patients classified by the MoCA as "cognitively intact", 78% showed impairment in at least one cognitive domain on neuropsychological assessment [15]; missed impairments were most frequent in general intelligence, processing speed, and non-verbal memory, which are not assessed by the MoCA. A high proportion of patients were also found to have executive dysfunction, a domain that is only partially assessed by the MoCA; this finding was recently replicated in another stroke cohort [16].…”

Section: Introductionmentioning

confidence: 99%

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Additional Queen Square (QS) screening items improve the test accuracy of the Montreal Cognitive Assessment (MoCA) after acute stroke

Chan

Garritsen

Altendorff

et al. 2019

Journal of the Neurological Sciences

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Background: The Montreal Cognitive Assessment (MoCA) is a popular cognitive screening tool used in stroke, but lacks sensitivity for detecting impairment in stroke-relevant domains of processing speed, non-verbal memory and executive functions. Our aim was to assess whether the test accuracy of the MoCA can be improved with additional tailored screening items targeting these three domains. Methods: We included 196 patients admitted to an acute stroke unit at the National Hospital for Neurology and Neurosurgery, Queen Square (QS), London. Participants completed the MoCA as well as a series of additional QS-screening items designed to assess speed of processing, non-verbal memory and executive functions. Performance on the MoCA and QS screening items was compared with performance on "gold standard" neuropsychological assessment. Results: In our sample, 22% of patients were classified as "cognitively intact" on the traditional MoCA alone (>25). However, when tested on the QS-screening items, 40% of these patients failed on speed of processing, 56% failed on non-verbal memory and 26% failed on executive functions. Compared with neuropsychological assessment, the QSscreening items had good sensitivity (QS-Speed: 0.85; QS-Vis: 0.71; QS-EF: 0.73) and modest specificity (QS-Speed: 0.59; QS-Vis: 0.39; QS-EF: 0.54), regardless of stroke lateralisation. Conclusion: Additional screening items detected impairments in speed of processing, nonverbal memory and executive functions over and above those captured using the standard MoCA. The use of these QS-screening items improves the detection of post-stroke cognitive deficits in domains not adequately covered by the standard MoCA.

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The test accuracy of the montreal cognitive assessment (MoCA) in stroke

Cited by 5 publications

References 0 publications

Discharge Destination from a Rehabilitation Unit After Acute Ischemic Stroke

Discharge Destination from a Rehabilitation Unit After Acute Ischemic Stroke

Cognitive Function Differences based on Hemispheric Lesions of First-Ever Ischemic Stroke Patients

Additional Queen Square (QS) screening items improve the test accuracy of the Montreal Cognitive Assessment (MoCA) after acute stroke

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