This study uses the same methods and participant population reported previously. Therefore, our primary aim was to examine the association of declining MoCA and MMSE test scores from sub-acute stroke phase to chronic stroke phase, with the decline in neuropsychological diagnosis from 3–6 months after stroke to a year later. However, the utility of a decline in brief screening test scores through consecutive assessments over time in suggesting deterioration of neuropsychological diagnosis is unknown and should be investigated. Recently, the changing scores of MoCA, through multiple assessments over 90 days after stroke event have been reported to map the temporal patterns of transient cognitive deficits. To date, two studies reported that the MMSE and MoCA were both predictive of cognitive impairment determined by formal neuropsychological assessments at 3–6 months after the index cerebrovascular event. įew studies have evaluated the abilities of MMSE and MoCA scores within two weeks after stroke event (sub-acute stroke phase) for predicting cognitive impairment at chronic stroke phase. The superiority of MoCA over MMSE in detecting cognitive impairment is debatable as findings from previous studies are mixed, with some studies recommending the MoCA while others reported that both instruments are equivalent. By including frontal-executive function items such as trail test, clock drawing and copying a cube as well as abstract reasoning such as similarities test, MoCA may be relatively more sensitive to detect characteristic cognitive deficits in VCI. The Montreal Cognitive Assessment (MoCA) is a relatively new screening instrument developed to detect mild cognitive impairment. However, it has been criticized for inadequate criterion validity especially in detecting VCI due to lack of frontal-executive function test items. The Mini-Mental State Examination (MMSE) is one of the most widely used cognitive screening instruments. Thus changing cognitive test scores may be a timesaving measures to aid cognitive recovery with appropriate rehabilitation to prevent further deterioration. Ĭognitive screening using brief tests is therefore essential to detect VCI and more importantly, decline in brief cognitive test scores over time may be useful in approximating deterioration in cognitive decline as diagnosed by a formal neuropsychological test battery. Furthermore, the severity of VCIND differentially predicts survival such that moderate VCIND patients are 3–4 times more likely to die than mild VCIND patients and those without cognitive impairment within the follow-up period of 5 years. The prognosis of VCI is poor, with higher mortality rate and poorer functional outcome as compared to patients without cognitive impairment. Both VCIND and VaD are considered part of the spectrum of vascular cognitive impairment (VCI). Vascular cognitive impairment with no dementia (VCIND) is even more prevalent in post-stroke patients, with a reported rate of 47.7%. Post-stroke dementia includes vascular dementia (VaD) among others. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭognitive deficits are common after stroke with 10% of patients developing dementia after their first-ever stroke and more than 30% had dementia after recurrent stroke. Dong was a recipient of the NUHS National Clinician Scientist Program award during this study. He can be contacted at the Memory Ageing and Cognition Center, Department of Pharmacology, Yoo Loo Lin School of Medicine, National University Health System, Singapore.įunding: This study is funded by a Center Grant (NMRC/CG/NUHS/2010) from the National Medical Research Council ( ). Christopher Li-Hsian Chen (email: who is acknowledged as a co-author in this study. Interested researchers may request access to the data in writing to Dr. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Because participants did not consent to have the data released publicly, the data underlying this study are available upon request. Received: JAccepted: FebruPublished: March 27, 2017Ĭopyright: © 2017 Tan et al. PLoS ONE 12(3):Įditor: Masaki Mogi, Ehime University Graduate School of Medicine, JAPAN (2017) Decline in changing Montreal Cognitive Assessment (MoCA) scores is associated with post-stroke cognitive decline determined by a formal neuropsychological evaluation. Citation: Tan HH, Xu J, Teoh HL, Chan BP-L, Seet RCS, Venketasubramanian N, et al.
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