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Evaluation of cognitive impairment by the Montreal cognitive assessment in patients with aneurysmal subarachnoid haemorrhage: prevalence, risk factors and correlations with 3 month outcomes.
- Source :
-
Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2012 Nov; Vol. 83 (11), pp. 1112-7. Date of Electronic Publication: 2012 Jul 31. - Publication Year :
- 2012
-
Abstract
- Objective: Identification of patients with aneurysmal subarachnoid haemorrhage (aSAH) with cognitive impairment is important for patient management (medical treatment, cognitive rehabilitation and social arrangements). The Montreal cognitive assessment (MoCA) is currently recommended over the mini-mental state examination (MMSE) by the U.S. National Institute of Neurological Disorder, in the chronic post-stroke setting. We hypothesised that the MoCA has a better correlation with functional outcome at 3 months than the MMSE.<br />Methods: We carried out a prospective observational study in Hong Kong over a 2 year period, recruiting patients aged 21-75 years with aSAH admitted within 96 h of ictus. The assessments included the modified Rankin Scale, Lawton Instrumental Activity of Daily Living (IADL), Short Form-36, MoCA and MMSE at 3 months after ictus. Analyses were carried out to compare MoCA with MMSE.<br />Results: 90 patients completed the 3 month assessments. Cognitive impairment (MoCA <26) was determined in 73% of patients at 3 months. Delayed cerebral infarction explained the 31-38% variance in cognitive outcomes (MMSE and MoCA) at 3 months. MoCA demonstrated good discrimination of favourable neurological and IADL outcomes similar to the MMSE in receiver operating characteristics curve analyses.<br />Conclusions: MoCA defined cognitive impairment was common at 3 months after aSAH and MoCA correlated with functional outcomes similar, but not superior, to the MMSE. The study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).
- Subjects :
- Adult
Aged
Cognition Disorders complications
Cognition Disorders epidemiology
Hong Kong epidemiology
Humans
Male
Middle Aged
Outcome Assessment, Health Care methods
Predictive Value of Tests
Prevalence
Prospective Studies
ROC Curve
Risk Factors
Subarachnoid Hemorrhage complications
Subarachnoid Hemorrhage epidemiology
Cognition Disorders diagnosis
Cognition Disorders psychology
Neuropsychological Tests statistics & numerical data
Outcome Assessment, Health Care statistics & numerical data
Subarachnoid Hemorrhage psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-330X
- Volume :
- 83
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 22851612
- Full Text :
- https://doi.org/10.1136/jnnp-2012-302217