Montreal Cognitive Assessment—A 10-Minute Test—May Predict Long-Term Outcomes for Patients with Stroke
In a prospective study (Neurology. 2018:October 18.) of 274 patients in France and Germany, the Montreal Cognitive Assessment (MoCA) was administered 1 week after these patients had experienced a stroke. Based on the MoCA results, patients were categorized as having (MoCA score < 26)or not having cognitive impairments poststroke. Follow up tests measuring cognition, memory, motor skills, and ability to perform daily living tasks were administered 6 months, 1 year, and 3 years.
At the 3-year point of the study, patients who had been identified as having cognitive deficits at week 1 had higher rates of mortality (17% vs 3%), motor skill deficits (29% vs 5%), and difficulties with activities of daily living (42% vs 13%). Results were controlled for age, sex, level of education, presence of vascular risk factors or prestroke cognitive deficits, and stroke severity (using the National Institute of Health Stroke Scale [NIHSS]).
“We found that this test, which takes less than 10 minutes, can help predict whether people will have impaired thinking skills, problems that keep them from performing daily tasks such as bathing and dressing, and even whether they will be more likely to die,” said study author Martin Dichgans, MD, of Ludwig-Maximilians University in Munich, Germany. “This test should be used to screen people with stroke and to counsel them and their families about long-term prognosis and also to identify those who would most benefit from interventions that could improve their outcomes.”