Decline in changing Montreal Cognitive Assessment (MoCA) scores is associated with post-stroke cognitive decline determined by a formal neuropsychological evaluation

PLoS One. 2017 Mar 27;12(3):e0173291. doi: 10.1371/journal.pone.0173291. eCollection 2017.

Abstract

Objectives: We aimed to examine changes in the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores within a one-year period after stroke/transient ischemic attack (TIA) in associating cognitive decline determined by a formal neuropsychological test battery.

Methods: Patients with ischemic stroke/TIA received MoCA and MMSE at baseline within 14 days after stroke/TIA, at 3-6 months and 1-year follow-ups. The scores of MoCA and MMSE were considered to have declined if there were a reduction of ≥2 points in the respective scores measured across two time points. The decline in neuropsychological diagnosis transitional status was defined by a category transition from no cognitive impairment or any cognitive impairment to a more severe cognitive impairment or dementia.

Results: 275 patients with a mean age of 59.8 ± 11.6 years, and education of 7.7 ± 4.3 years completed all the assessments at baseline, 3-6 months and 1-year follow-ups. A decline in MoCA scores from 3-6 months to 1 year was associated with higher risk of decline in diagnosis transitional status (odd ratio = 3.21, p = 0.004) in the same time period whereas there was no association with a decline in MMSE scores.

Conclusions: The decline in MoCA scores from 3-6 months to 1 year after stroke/TIA has three times higher risk for decline in the diagnosis transitional status. The decline of MoCA scores (reduction ≥ 2points) is associated with the decline in neuropsychological diagnosis transitional status.

MeSH terms

  • Adult
  • Aged
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology*
  • Dementia / diagnosis
  • Dementia / etiology
  • Educational Status
  • Female
  • Follow-Up Studies
  • Humans
  • Ischemic Attack, Transient / complications*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Risk Factors
  • Stroke / complications*

Grants and funding

This study is funded by a Center Grant (NMRC/CG/NUHS/2010) from the National Medical Research Council (http://www.nmrc.gov.sg/). Y. Dong was a recipient of the NUHS National Clinician Scientist Program award during this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.