Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke.

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Title: Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke.
Authors: Cumming, T. B., Churilov, L., Linden, T., Bernhardt, J.
Source: Acta Neurologica Scandinavica. Aug2013, Vol. 128 Issue 2, p122-129. 8p.
Subjects: Mild cognitive impairment, Mini-Mental State Examination, Stroke, Neuropsychology, Hemorrhage
Abstract: Objective To determine the validity of the Montreal Cognitive Assessment ( Mo CA) and the Mini- Mental State Examination ( MMSE) as screening tools for cognitive impairment after stroke. Materials and methods Cognitive assessments were administered over 2 sessions (1 week apart) at 3 months post-stroke. Scores on the Mo CA and MMSE were evaluated against a diagnosis of cognitive impairment derived from a comprehensive neuropsychological battery (the criterion standard). Results Sixty patients participated in the study [mean age 72.1 years ( SD = 13.9), mean education 10.5 years ( SD = 3.9), median acute NIHSS score 5 ( IQR 3-7)]. The Mo CA yielded lower scores (median = 21, IQR = 17-24; mean = 20.0, SD = 5.4) than the MMSE (median = 26, IQR = 22-27; mean = 24.2, SD = 4.5). MMSE data were more skewed towards ceiling than Mo CA data (skewness = −1.09 vs −0.73). Area under the receiver operator curve was higher for Mo CA than for MMSE (0.87 vs 0.84), although this difference was not significant (χ2 = 0.48, P = 0.49). At their optimal cut-offs, the Mo CA had better sensitivity than the MMSE (0.92 vs 0.82) but poorer specificity (0.67 vs 0.76). Conclusions The Mo CA is a valid screening tool for post-stroke cognitive impairment; it is more sensitive but less specific than the MMSE. Contrary to the prevailing view, the MMSE also exhibited acceptable validity in this setting. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:Objective To determine the validity of the Montreal Cognitive Assessment ( Mo CA) and the Mini- Mental State Examination ( MMSE) as screening tools for cognitive impairment after stroke. Materials and methods Cognitive assessments were administered over 2 sessions (1 week apart) at 3 months post-stroke. Scores on the Mo CA and MMSE were evaluated against a diagnosis of cognitive impairment derived from a comprehensive neuropsychological battery (the criterion standard). Results Sixty patients participated in the study [mean age 72.1 years ( SD = 13.9), mean education 10.5 years ( SD = 3.9), median acute NIHSS score 5 ( IQR 3-7)]. The Mo CA yielded lower scores (median = 21, IQR = 17-24; mean = 20.0, SD = 5.4) than the MMSE (median = 26, IQR = 22-27; mean = 24.2, SD = 4.5). MMSE data were more skewed towards ceiling than Mo CA data (skewness = −1.09 vs −0.73). Area under the receiver operator curve was higher for Mo CA than for MMSE (0.87 vs 0.84), although this difference was not significant (χ2 = 0.48, P = 0.49). At their optimal cut-offs, the Mo CA had better sensitivity than the MMSE (0.92 vs 0.82) but poorer specificity (0.67 vs 0.76). Conclusions The Mo CA is a valid screening tool for post-stroke cognitive impairment; it is more sensitive but less specific than the MMSE. Contrary to the prevailing view, the MMSE also exhibited acceptable validity in this setting. [ABSTRACT FROM AUTHOR]
ISSN:00016314
DOI:10.1111/ane.12084