BACKGROUND: The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were compared with and without the addition of a brief processing speed test, the symbol digit modalities test (SDMT), for vascular cognitive impairment (VCI) screening at three to six months after stroke. METHODS: Patients with ischemic stroke and transient ischemic attack were assessed with MoCA and MMSE, as well as a formal neuropsychological battery three to six months after stroke. VCI was defined by impairment in any cognitive domain on neuropsychological testing. The area under the receiver operating characteristic curve (AUC) was used to compare test discriminatory ability. RESULTS: One hundred and eighty-nine patients out of 327 (58%) had VCI, of whom 180 (95%) had vascular mild cognitive impairment (VaMCI), and nine (5%) had dementia. The overall AUCs of the MoCA and MMSE scores and performance at their respective cut-off points were equivalent in detecting VCI (AUCs: 0.87 (95% CI 0.83-0.91) vs. 0.84 (95% CI 0.80-0.88), p = 0.13; cut-offs: MoCA (≤23) vs. MMSE (≤26), sensitivity: 0.78 vs. 0.71; specificity: 0.80 vs. 0.82; positive predictive value: 0.84 vs. 0.84; negative predictive value: 0.72 vs. 0.67; and correctly classified 78.6% vs. 75.5%; p = 0.42). The AUCs of MMSE and MoCA were improved significantly by the SDMT (AUCs: MMSE+SDMT 0.90 (95% CI 0.87-0.93), p <0.001; MoCA+SDMT 0.91 (95% CI 0.88-0.94), p < 0.02). CONCLUSIONS: The MoCA and MMSE are equivalent and moderately sensitive, and can be supplemented with the SDMT to improve their accuracy in VCI screening.
BACKGROUND: The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were compared with and without the addition of a brief processing speed test, the symbol digit modalities test (SDMT), for vascular cognitive impairment (VCI) screening at three to six months after stroke. METHODS:Patients with ischemic stroke and transient ischemic attack were assessed with MoCA and MMSE, as well as a formal neuropsychological battery three to six months after stroke. VCI was defined by impairment in any cognitive domain on neuropsychological testing. The area under the receiver operating characteristic curve (AUC) was used to compare test discriminatory ability. RESULTS: One hundred and eighty-nine patients out of 327 (58%) had VCI, of whom 180 (95%) had vascular mild cognitive impairment (VaMCI), and nine (5%) had dementia. The overall AUCs of the MoCA and MMSE scores and performance at their respective cut-off points were equivalent in detecting VCI (AUCs: 0.87 (95% CI 0.83-0.91) vs. 0.84 (95% CI 0.80-0.88), p = 0.13; cut-offs: MoCA (≤23) vs. MMSE (≤26), sensitivity: 0.78 vs. 0.71; specificity: 0.80 vs. 0.82; positive predictive value: 0.84 vs. 0.84; negative predictive value: 0.72 vs. 0.67; and correctly classified 78.6% vs. 75.5%; p = 0.42). The AUCs of MMSE and MoCA were improved significantly by the SDMT (AUCs: MMSE+SDMT 0.90 (95% CI 0.87-0.93), p <0.001; MoCA+SDMT 0.91 (95% CI 0.88-0.94), p < 0.02). CONCLUSIONS: The MoCA and MMSE are equivalent and moderately sensitive, and can be supplemented with the SDMT to improve their accuracy in VCI screening.
Authors: Anne M Murray; Le Thi Phuong Thao; Joanne Ryan; Rory Wolfe; James B Wetmore; Robyn L Woods; Kevan R Polkinghorne Journal: Kidney360 Date: 2021-12-07
Authors: H M Boss; S M Van Schaik; I A Deijle; E C de Melker; B T J van den Berg; E J A Scherder; W M J Bosboom; H C Weinstein; R M Van den Berg-Vos Journal: BMJ Open Date: 2014-12-31 Impact factor: 2.692
Authors: Seon Jin Yim; Dahyun Yi; Min Soo Byun; Young Min Choe; Hyo Jung Choi; Hyewon Baek; Bo Kyung Sohn; Jee Wook Kim; Eui-Jung Kim; Dong Young Lee Journal: Psychiatry Investig Date: 2017-09-11 Impact factor: 2.505
Authors: Polly Scutt; Dan Blackburn; Kailash Krishnan; Clive Ballard; Alistair Burns; Gary A Ford; Jonathan Mant; Peter Passmore; Stuart Pocock; John Reckless; Nikola Sprigg; Rob Stewart; Joanna M Wardlaw; Philip M Bath Journal: Trials Date: 2015-11-07 Impact factor: 2.279