蒙特利尔认知评估
医学
接收机工作特性
冲程(发动机)
内科学
神经心理学
认知
认知障碍
曲线下面积
神经心理评估
小型精神状态检查
物理疗法
心脏病学
精神科
机械工程
工程类
作者
Yi Dong,Narayanaswamy Venketasubramanian,Bernard Chan,Vijay K. Sharma,Melissa J. Slavin,Simon L. Collinson,Perminder S. Sachdev,Yiong Huak Chan,Christopher Chen
标识
DOI:10.1136/jnnp-2011-302070
摘要
Objectives
To determine the prognostic value of brief cognitive screening tests administered in the subacute stroke phase (initial 2 weeks) for the detection of significant cognitive impairment 3–6 months after stroke, the authors compared the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Methods
Patients with ischaemic stroke and transient ischaemic attack were assessed with both MoCA and MMSE within 14 days after index stroke, followed by a formal neuropsychological evaluation of seven cognitive domains 3–6 months later. Cognitive outcomes were dichotomised as either no–mild (impairment in ≤2 cognitive domains) or moderate–severe (impairment in ≥3 cognitive domains) vascular cognitive impairment. Area under the receiver operating characteristic (ROC) curve analysis was used to compare discriminatory ability. Results
300 patients were recruited, of whom 239 received formal neuropsychological assessment 3–6 months after the stroke. 60 (25%) patients had moderate–severe VCI. The overall discriminant validity for detection of moderate–severe cognitive impairment was similar for MoCA (ROC 0.85 (95% CI 0.79 to 0.90) and MMSE (ROC 0.83 (95% CI 0.77 to 0.89)), p=0.96). Both MoCA (21/22) and MMSE (25/26) had similar discriminant indices at their optimal cutoff points; sensitivity 0.88 versus 0.88; specificity 0.64 versus 0.67; 70% versus 72% correctly classified. Moreover, both tests had similar discriminant indices in detecting impaired cognitive domains. Conclusions
Brief screening tests during acute admission in patients with mild stroke are predictive of significant vascular cognitive impairment 3–6 months after stroke.
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