Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
Geriatr Gerontol Int. 2017 Dec;17(12):2329-2335. doi: 10.1111/ggi.13069. Epub 2017 Jul 4.
The Montreal Cognitive Assessment (MoCA) has been shown to be more sensitive in detecting executive dysfunction than the Mini-Mental State Examination (MMSE). However, it is still not known whether all the MoCA executive subtests contribute to the superior sensitivity. Thus, the present study aimed to determine how much executive abnormality was detected by the MMSE and MoCA executive subtests in a population-based cohort of Chinese post-stroke patients.
The MMSE and MoCA were collected from post-stroke patients (within 15 days to 1 month after stroke, including ischemic stroke and hemorrhagic stroke) in 14 hospitals of northern and southern China (including 10 top-graded hospitals and 4 community hospitals) between June 2011 and September 2013. The proportions of patients with incorrect MoCA executive subtests and the proportions of patients with incorrect MMSE executive subtests were compared.
A total of 1222 patients (703 men and 519 women, aged 62.06 ± 10.68 and 62.76 ± 9.86 years, respectively) were recruited. The MoCA detected more patients with executive dysfunction than the MMSE (OR 15.399, 95% CI 12.631-18.773; P < 0.001). The likelihood of incorrect MMSE executive tasks increased across decreasing scores of MoCA executive tasks (P < 0.001 for trend). Compared with the MMSE three-step command test (15.5%), the MoCA trail-making (57.8%), abstraction (48.0%) and abstraction (measurement tool; 45.7%) detected more patients with executive dysfunction (P < 0.001), whereas the MoCA digit span forwards (4.3%) and backwards (11.6%) detected fewer patients (P < 0.001 and P = 0.005, respectively).
The MoCA executive tasks are more sensitive in detecting executive dysfunction compared with the MMSE executive tasks. Geriatr Gerontol Int 2017; 17: 2329-2335.
蒙特利尔认知评估（MoCA）在检测执行功能障碍方面比简易精神状态检查（MMSE）更敏感。然而，目前尚不清楚 MoCA 的所有执行子测试是否都有助于提高敏感性。因此，本研究旨在确定在基于人群的中国脑卒中患者队列中，MMSE 和 MoCA 执行子测试检测到多少执行异常。
2011 年 6 月至 2013 年 9 月，在中南部地区的 14 家医院（包括 10 家顶级医院和 4 家社区医院）中收集了脑卒中患者（脑卒中后 15 天至 1 个月内，包括缺血性卒中和出血性卒中）的 MMSE 和 MoCA。比较了 MoCA 执行子测试错误的患者比例和 MMSE 执行子测试错误的患者比例。
共纳入 1222 例患者（703 例男性，519 例女性，年龄 62.06±10.68 岁和 62.76±9.86 岁）。MoCA 检测到的执行功能障碍患者多于 MMSE（OR 15.399，95%CI 12.631-18.773；P<0.001）。MoCA 执行任务评分越低，MMSE 执行任务错误的可能性越大（趋势 P<0.001）。与 MMSE 三步指令测试（15.5%）相比，MoCA 连线测试（57.8%）、抽象（48.0%）和抽象（测量工具；45.7%）检测到更多的执行功能障碍患者（P<0.001），而 MoCA 数字跨度向前（4.3%）和向后（11.6%）检测到的患者较少（P<0.001 和 P=0.005）。
MoCA 执行任务比 MMSE 执行任务更能敏感地检测执行功能障碍。老年医学与老年病学杂志 2017；17：2329-2335。
