Department of Neurology, Beijing Tiantan Hospital, Capital Medical University , Beijing, China.
National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing, China.
Neurol Res. 2021 Jan;43(1):15-21. doi: 10.1080/01616412.2020.1819070. Epub 2020 Sep 23.
Cognitive impairment usually occurs in the acute phase after stroke, but most stroke survivors experience some form of long-term cognitive deficit. The aim of this study was to establish the cutoff point of the Montreal Cognitive Assessment (MoCA-Beijing) in screening for cognitive impairment (CI) at 6 months of ischemic stroke or transient ischemic attack (TIA).
A total of 301 stroke patients and 15 TIA patients were recruited. Patients were assessed at six months by the MoCA-Beijing and a formal neuropsychological battery. The 1.5 SD below the level of the norm on several tests indicated cognitive impairment (CI).
Most stroke and TIA patients were in their 60s (61.23 ± 10.60 years old). The optimal cutoff point for MoCA-Beijing in discriminating patients with CI from those with no cognitive impairment (NCI) was 24/25 (sensitivity 63.28%, specificity 71.22%, PPV = 73.68%, NPV = 60.37%, classification accuracy = 66.72%). The predominant cognitive deficits were visuospatial ability (84.85%), and then attention/executive function (79.27%).
The MoCA-Beijing cutoff score for differentiating CI from NCI after stroke and TIA at six months was at 24/25, and it is important for routine clinical practice.
认知障碍通常发生在中风后的急性期，但大多数中风幸存者都经历某种形式的长期认知缺陷。本研究旨在确定蒙特利尔认知评估（MoCA-北京）的截值，以筛查缺血性中风或短暂性脑缺血发作（TIA）后 6 个月的认知障碍（CI）。
共纳入 301 例中风患者和 15 例 TIA 患者。患者在 6 个月时接受 MoCA-北京和正式神经心理学测试评估。多项测试的 1.5 个标准差低于正常水平表明存在认知障碍（CI）。
大多数中风和 TIA 患者年龄在 60 多岁（61.23±10.60 岁）。MoCA-北京区分 CI 患者和无认知障碍（NCI）患者的最佳截断值为 24/25（灵敏度 63.28%，特异性 71.22%，PPV=73.68%，NPV=60.37%，分类准确性=66.72%）。主要的认知缺陷是视空间能力（84.85%），其次是注意力/执行功能（79.27%）。
MoCA-北京用于区分中风和 TIA 后 6 个月 CI 和 NCI 的截断值为 24/25，这对常规临床实践很重要。
