10.5061/DRYAD.7H083RD
Zietemann, Vera
Ludwig Maximilian University of Munich
Georgakis, Marios K
Ludwig Maximilian University of Munich
Dondaine, Thibaut
University of Lille
Müller, Claudia
Ludwig Maximilian University of Munich
Mendyk, Anne-Marie
University of Lille
Kopczak, Anna
Ludwig Maximilian University of Munich
Hénon, Hilde
University of Lille
Bombois, Stéphanie
University of Lille
Wollenweber, Frank Arne
Ludwig Maximilian University of Munich
Bordet, Régis
University of Lille
Dichgans, Martin
Munich Cluster for Systems Neurology
Data from: Early MoCA predicts long-term cognitive and functional outcome
and mortality after stroke
Dryad
dataset
2019
Neuropsychological assessment
Cerebrovascular disease/Stroke
rehabilitation
Natural history studies (prognosis)
Assessment of cognitive disorders/dementia
2019-08-02T00:00:00Z
2019-08-02T00:00:00Z
en
https://doi.org/10.1212/wnl.0000000000006506
310390 bytes
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CC0 1.0 Universal (CC0 1.0) Public Domain Dedication
Objective: To examine whether the Montreal Cognitive Assessment (MoCA)
administered within 7 days after stroke predicts long-term cognitive
impairment, functional impairment, and mortality. Methods: MoCA was
administered to 274 patients from two prospective hospital-based cohort
studies in Germany (n=125) and France (n=149). Cognitive and functional
outcomes were assessed at 6, 12 and 36 months post-stroke by comprehensive
neuropsychological testing, the Clinical Dementia Rating (CDR) scale,
modified Rankin Scale (mRS), and Instrumental Activities of Daily Living
(IADL), and analyzed using generalized estimating equations. All-cause
mortality was investigated by Cox proportional hazard models. Analyses
were adjusted for demographic variables, education, vascular risk factors,
premorbid cognitive status, and NIH Stroke Scale scores. The additive
predictive value of MoCA was examined using receiver operating
characteristic curves. Results: In pooled analyses a baseline MoCA
<26 was associated with cognitive impairment, defined by
neuropsychological testing (OR: 5.30, 95%CI: 2.75-10.22) and by CDR ≥0.5
(OR: 2.53, 95%CI: 1.53-4.18), functional impairment, defined by mRS
>2 (OR: 5.03, 95%CI: 2.20-11.51) and by IADL <8 (OR: 2.48,
95%CI: 1.40-4.38), and mortality (HR: 7.24, 95%CI: 1.99-26.35) across the
3-year follow-up. Patients with MoCA <26 performed worse across all
prespecified cognitive domains (executive function/attention, memory,
language, visuospatial ability). MoCA increased the area under the curve
for predicting cognitive impairment (neuropsychological testing; 0.81 vs.
0.72, p=0.01) and functional impairment (mRS >2; 0.88 vs. 0.84,
p=0.047). Conclusion: Early cognitive testing by MoCA predicts long-term
cognitive outcome, functional outcome and mortality after stroke. Our
results support routine use of the MoCA in stroke patients.
SupplementMoCA_suppl_rev.pdf