The Montreal cognitive assessment is superior to national institute of neurological disease and stroke-Canadian stroke network 5-minute protocol in predicting vascular cognitive impairment at 1?year

摘要

Background The predictive ability of National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol and Montreal Cognitive Assessment (MoCA) administered sub-acutely and at the convalescent phase after stroke for significant vascular cognitive impairment (VCI) at 1?year is unknown. We compared prognostic values of these tests. Methods Patients with ischemic stroke and transient ischemic attack (TIA) received MoCA sub-acutely (within 2?weeks) and 3–6 months after stroke followed by a formal neuropsychological evaluation at 1?year. The total score of NINDS-CSN 5-minutes protocol was derived from MoCA. Moderate-severe VCI was defined as neuropsychological impairment in?≥?3 domains. Area under the receiver operating characteristic curve (AUC) analyses were conducted to establish the optimal cutoff points and discriminatory properties of the MoCA and NINDS-CSN 5-minute protocol in detecting moderate-severe VCI. Results Four hundre patients were recruited at baseline. Of these, 291 received a formal neuropsychological assessment 1?year after stroke. 19?% patients had moderate-severe VCI. The MoCA was superior to the NINDS-CSN 5-minute protocol [sub-acute AUCs: 0.89 vs 0.80, p Conclusions MoCA administered sub-acutely and 3–6 months after stroke is superior to the NINDS-CSN 5-minute protocol in predicting moderate-severe VCI at 1?year.