Application of MoCA and MMSE in screening for cognitive impairment in acute ischemic stroke

Abstract

Objective To compare the applicability of the Beijing Version of the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE) in screening for cognitive impairment in patients with acute ischemic stroke for 2-3 weeks. Methods MoCA and MMSE were conducted in 201 patients with acute ischemic stroke within 2 to 3 weeks after the onset of stroke. With MoCA<23 and MMSE<26 as the cut off value, we assessed the clinic effect of the MoCA and MMSE and explored the correlation between two instruments. Results The average scores of MoCA and MMSE scale were (20.5±4.3) and (25.4±3.5) points. The prevalence of cognitive impairment evaluated with MoCA and MMSE were 57.2% and 43.3%, respectively.MoCA showed significant correlation with MMSE score (Pearson's correlation coefficient=0.833, P<0.001), and an agreement with Kappa values of 0.532 (P<0.01) in screening for cognitive impairment. Conclusions The prevalence of cognitive impairment assessed with MoCA is higher than that of with MMSE when using MoCA<23 and MMSE<26 as the cut off values. Both instruments show a good agreement for screening cognitive impairment in acute ischemic stroke within 2 to 3 weeks following the disease onset. Key words: Acute ischemic stroke; Cognitive impairment; Montreal Cognitive Assessment (MoCA); Mini Mental State Examination (MMSE)