Edgar Chan1, Sabah Khan2, Rupert Oliver2, Sumanjit K Gill3, David J Werring4, Lisa Cipolotti2. 1. National Hospital for Neurology and Neurosurgery, London, UK. Electronic address: edgar.chan@uclh.nhs.uk. 2. National Hospital for Neurology and Neurosurgery, London, UK. 3. University College London Hospital, London, UK. 4. UCL Institute of Neurology, Stroke Research Group, London, UK.
Abstract
BACKGROUND AND PURPOSE: The Montreal Cognitive Assessment (MoCA) is an increasingly popular clinical screening tool for detecting cognitive impairment in stroke, but few studies have directly compared performance on the MoCA with neuropsychological assessment. Our retrospective study examined the extent to which intact performance on the MoCA reflects intact cognition as determined by neuropsychological assessment. METHODS: In this retrospective study, cognitive profiles for 136 acute stroke patients admitted to the Acute Stroke Unit who had available MoCA and neuropsychological assessment data were examined. RESULTS: 22% of our patients were deemed cognitively intact on the MoCA. Of these, 78% were found to be impaired (≤ 5%ile) on neuropsychological assessment in one or more cognitive domains. The most common impairments were in general intelligence, information processing speed and visual memory; three areas not assessed by the MoCA. In addition, a high proportion (up to 59%) of patients who scored the maximum points in one of the MoCA-specified domains were impaired on comparable neuropsychological assessment. CONCLUSIONS: Our findings suggest that although the MoCA may be a useful screening tool post-stroke in detecting gross impairments, neuropsychological assessment is still necessary for a comprehensive and reliable detection of domain-specific cognitive deficits, which can more reliably inform us for realistic goal setting and vocational advice vital for effective rehabilitation.
BACKGROUND AND PURPOSE: The Montreal Cognitive Assessment (MoCA) is an increasingly popular clinical screening tool for detecting cognitive impairment in stroke, but few studies have directly compared performance on the MoCA with neuropsychological assessment. Our retrospective study examined the extent to which intact performance on the MoCA reflects intact cognition as determined by neuropsychological assessment. METHODS: In this retrospective study, cognitive profiles for 136 acute strokepatients admitted to the Acute Stroke Unit who had available MoCA and neuropsychological assessment data were examined. RESULTS: 22% of our patients were deemed cognitively intact on the MoCA. Of these, 78% were found to be impaired (≤ 5%ile) on neuropsychological assessment in one or more cognitive domains. The most common impairments were in general intelligence, information processing speed and visual memory; three areas not assessed by the MoCA. In addition, a high proportion (up to 59%) of patients who scored the maximum points in one of the MoCA-specified domains were impaired on comparable neuropsychological assessment. CONCLUSIONS: Our findings suggest that although the MoCA may be a useful screening tool post-stroke in detecting gross impairments, neuropsychological assessment is still necessary for a comprehensive and reliable detection of domain-specific cognitive deficits, which can more reliably inform us for realistic goal setting and vocational advice vital for effective rehabilitation.
Authors: Lisa Cipolotti; Colm Healy; Edgar Chan; Sarah E MacPherson; Mark White; Katherine Woollett; Martha Turner; Gail Robinson; Barbara Spanò; Marco Bozzali; Tim Shallice Journal: Neuropsychologia Date: 2015-06-20 Impact factor: 3.139
Authors: Lisa Cipolotti; Sarah E MacPherson; Sara Gharooni; Natasja van-Harskamp; Tim Shallice; Edgar Chan; Parashkev Nachev Journal: Neuropsychologia Date: 2017-08-13 Impact factor: 3.139
Authors: Nele Demeyere; M J Riddoch; E D Slavkova; K Jones; I Reckless; P Mathieson; G W Humphreys Journal: J Neurol Date: 2015-11-20 Impact factor: 4.849