1. The Montreal Cognitive Assessment is superior to National Institute of Neurological Disease and Stroke-Canadian Stroke Network 5-minute protocol in predicting vascular cognitive impairment at 1 year.
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YanHong Dong, Jing Xu, Bernard Poon-Lap Chan, Raymond Chee Seong Seet, Venketasubramanian, Narayanaswamy, Hock Luen Teoh, Sharma, Vijay Kumar, Christopher Li-Hsian Chen, Dong, YanHong, Xu, Jing, Chan, Bernard Poon-Lap, Seet, Raymond Chee Seong, Teoh, Hock Luen, and Chen, Christopher Li-Hsian
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MONTREAL Cognitive Assessment ,CENTRAL nervous system abnormalities ,MILD cognitive impairment ,HEALTH outcome assessment ,COGNITION disorders diagnosis ,TRANSIENT ischemic attack diagnosis ,STROKE diagnosis ,COGNITION ,COMPARATIVE studies ,NEUROPSYCHOLOGICAL tests ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,EVALUATION research ,RECEIVER operating characteristic curves - Abstract
Background: The predictive ability of National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol and Montreal Cognitive Assessment (MoCA) administered sub-acutely and at the convalescent phase after stroke for significant vascular cognitive impairment (VCI) at 1 year is unknown. We compared prognostic values of these tests.Methods: Patients with ischemic stroke and transient ischemic attack (TIA) received MoCA sub-acutely (within 2 weeks) and 3-6 months after stroke followed by a formal neuropsychological evaluation at 1 year. The total score of NINDS-CSN 5-minutes protocol was derived from MoCA. Moderate-severe VCI was defined as neuropsychological impairment in ≥ 3 domains. Area under the receiver operating characteristic curve (AUC) analyses were conducted to establish the optimal cutoff points and discriminatory properties of the MoCA and NINDS-CSN 5-minute protocol in detecting moderate-severe VCI.Results: Four hundre patients were recruited at baseline. Of these, 291 received a formal neuropsychological assessment 1 year after stroke. 19% patients had moderate-severe VCI. The MoCA was superior to the NINDS-CSN 5-minute protocol [sub-acute AUCs: 0.89 vs 0.80, p < 0.01; 3-6 months AUCs: 0.90 vs 0.83, p < 0.01] in predicting for moderate-severe VCI at 1 year. At respective cutoff points, MoCA had significantly higher sensitivity than the NINDS-CSN 5-minute protocol at baseline (p = 0.01) and 3-6 months (p = 0.04).Conclusions: MoCA administered sub-acutely and 3-6 months after stroke is superior to the NINDS-CSN 5-minute protocol in predicting moderate-severe VCI at 1 year. [ABSTRACT FROM AUTHOR]- Published
- 2016
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