Ragnhild Munthe-Kaas1,2, Stina Aam3,4, Ingvild Saltvedt3,4, Torgeir Bruun Wyller2,5, Sarah T Pendlebury6,7, Stian Lydersen8, Hege Ihle-Hansen1,2,5. 1. Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway (R.M.-K., H.I.-H.). 2. Institute of Clinical Medicine, University of Oslo, Norway (R.M.-K., T.B.W., H.I.-H.). 3. Department of Neuromedicine and Movement Science (S.A., I.S.). 4. Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Norway (S.A., I.S.). 5. Department of Geriatric Medicine, Oslo University Hospital, Norway (T.B.W., H.I.-H.). 6. Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (S.T.P.). 7. NIHR Biomedical Research Centre, Department of Acute Internal Medicine, and Department of Gerontology, John Radcliffe Hospital, Oxford, United Kingdom (S.T.P.). 8. Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, NTNU-Norwegian University of Science and Technology, Trondheim, Norway (S.L.).
Abstract
BACKGROUND AND PURPOSE: We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neurocognitive disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria in a prospective observational study. METHODS: Consecutive participants able to complete a cognitive test battery and MoCA 3 months poststroke were included. The reference standard of neurocognitive disorder was defined as a score of ≥1.5 SD below the normative mean in ≥1 cognitive domain on the cognitive test battery. RESULTS: Among 521 participants (43.6% women; mean age/SD, 71.5/12.0 years; mean education/SD, 12.4/3.8 years), the area under the receiver operating characteristic curve of MoCA for neurocognitive disorder was 0.80 (95% CI, 0.76-0.84). Using the standard MoCA cutoff <26, sensitivity was 0.71 (0.69-0.79) with specificity of 0.73 (0.66-0.76). MoCA cutoff of <27 gave higher sensitivity (0.82 [0.77-0.85]) at the expense of specificity (0.60 [0.53-0.66]). DISCUSSION: MoCA has reasonable accuracy for poststroke neurocognitive disorder diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02650531.
BACKGROUND AND PURPOSE: We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neurocognitive disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria in a prospective observational study. METHODS: Consecutive participants able to complete a cognitive test battery and MoCA 3 months poststroke were included. The reference standard of neurocognitive disorder was defined as a score of ≥1.5 SD below the normative mean in ≥1 cognitive domain on the cognitive test battery. RESULTS: Among 521 participants (43.6% women; mean age/SD, 71.5/12.0 years; mean education/SD, 12.4/3.8 years), the area under the receiver operating characteristic curve of MoCA for neurocognitive disorder was 0.80 (95% CI, 0.76-0.84). Using the standard MoCA cutoff <26, sensitivity was 0.71 (0.69-0.79) with specificity of 0.73 (0.66-0.76). MoCA cutoff of <27 gave higher sensitivity (0.82 [0.77-0.85]) at the expense of specificity (0.60 [0.53-0.66]). DISCUSSION: MoCA has reasonable accuracy for poststroke neurocognitive disorder diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02650531.
Entities:
Keywords:
area under curve; cognition; cognitive dysfunction; dementia; stroke
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