In some cases, PSCI severity can worsen over time, perhaps because of an underlying degenerative or micro-vascular pathology.Įarly identification of patients at risk for PSCI is likely important for the assessment of subacute and long-term management strategies for stroke patients (e.g., rehabilitation, adherence to therapies and to risk factors control). PSCI is a clinical entity that encompasses all types of cognitive decline following an index stroke it may occur immediately or in the first months after stroke. In two-thirds of cases, PSCI corresponds to a mild cognitive impairment, in one third to dementia and significantly impacts the quality of life of stroke survivors. In collective perception as well as in clinical trials, disability after stroke is mainly intended as physical disability, although a broader vision that includes evaluation of cognitive impairment is recommended because more than half of stroke survivors experience post-stroke cognitive impairment (PSCI). The major burden of stroke concerns the chronic phase. Stroke is the second leading cause of death and the third leading cause of disability worldwide. ConclusionĪ bedside cognitive screening with the CDT helps identifying patients at higher risk of PSCI. A pathological baseline score on MoCA-B (< 24) did not predict increased risk of cognitive decline at follow-up nor increased predictivity of stand-alone CDT. In multi-adjusted (for age, education, comorbidities score, NIHSS at admission and atrophy score) model, a pathological score on baseline CDT (< 6.55) was associated with a higher risk of PSCI at follow-up (HR 2.022 95% CI 1.025–3.989, p < 0.05) with respect to non-pathological scores. In comparison with patients who remained cognitively stable at follow-up, these patients were older, less educated, had more comorbidities, a higher score on the National Institutes of Health Stroke Scale (NIHSS) at admission, more severe cerebral atrophy, and lower MoCA-B and CDT scores at baseline. At follow-up (mean duration ± SD 12.8 ± 8.7 months), 28 (18.9%) incident cases of MCI and 27 (18%) cases of dementia were recorded. Out of 191 stroke survivors who were non-demented at baseline, 168 attended at least one follow-up visit. MethodsĪ cognitive assessment within a few days of ischemic or hemorrhagic stroke was performed in patients consecutively admitted to a stroke unit over 14 months by means of the Clock Drawing Test (CDT) and the Montreal Cognitive Assessment-Basic (MoCA-B). We aimed to determine the predictivity of two screening cognitive tests on the occurrence of mild cognitive impairment or dementia in acute stroke patients. Epub 2014 Nov 11.The early detection of patients at risk of post-stroke cognitive impairment (PSCI) may help planning subacute and long-term care. doi: 10.1089/tmj.2019.0134.Ī feasibility study of conducting the Montreal Cognitive Assessment remotely in individuals with movement disordersĪ Abdolahi, MT Bull, KC Darwin… – Health informatics …, 2016 – Iiboshi K, Yoshida K, Yamaoka Y, Eguchi Y, Sato D, Kishimoto M, Funaki K, Mimura M, Kishimoto T. ![]() ![]() 2019 Dec 9:1357633X19890788.Ī Validation Study of the Remotely Administered Montreal Cognitive Assessment Tool in the Elderly Japanese Population. Here are some references validating the remote administration of the MoCA :Ĭomparing face-to-face and videoconference completion of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke.Ĭhapman JE, Cadilhac DA, Gardner B, Ponsford J, Bhalla R, Stolwyk RJ. On that page, select the version (MoCa Audiovisual) and language (MoCA Test Full – Telemed instructions), then choose one of the options listed below, then click on Download Test. To download the modified instructions and audiovisual stimuli files, please log in to your account, click MoCA TEST, choose PAPER. Test and Instructions are now available on the website as well as the initial validation results comparing the 5 min version to the full version.įull version can be administered via Skype, FaceTime, or Teleconference, or any locally approved platform. You can download the Blind version of the MoCA from our website and administer it over the phone. MoCA without the visual elements, scored out of 22. Here are a few options that have been validated to use for remote testing:
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