Characteristics of Mini-Mental State Examination 1 year after stroke.
OBJECTIVE
The Mini-Mental State Examination (MMSE) is commonly used to evaluate cognition after stroke. The purpose of this study was to describe the properties of MMSE in relation to different stroke characteristics.


METHODS
Subjects were survivors (n = 253) of a population-based cohort who had had a first-ever stroke 1 year earlier. At baseline, patients were evaluated with regard to stroke type, stroke severity, unilateral neglect, and prestroke dementia. The 1-year follow-up included an MMSE, a functional evaluation according to the modified Rankin Scale (MRS) and a question regarding subjective memory problems.


RESULTS
The mean MMSE was 24.9. Patients with lacunar infarction scored 26.6. Impact of hemisphere localization was insignificant. Twenty-nine percent of the patients had cognitive impairment (cut-off <24). After adjustment for age and education, 16% had cognitive impairment; 41% of the patients had subjective memory problems. The kappa-value between subjective memory problems and dichotomized MMSE was 0.21. Patients with cognitive impairment scored at average 1.8 higher on the MRS.


CONCLUSIONS
If cut-off is used, the MMSE should be adjusted for age and education; otherwise the prevalence of cognitive impairment may be overestimated. Cognitive impairment heavily influences functional outcome. Subjective memory problems correlate poorly with MMSE. The impact of hemisphere location may previously have been overestimated.
Appelros
P
P
Department of Neurology, Orebro University Hospital, Orebro, Sweden. peter.appelros@orebroll.se
D000367:Age Factors; D000368:Aged; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology / Q000473:pathology / Q000523:psychology; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000453:epidemiology / Q000473:pathology / Q000523:psychology; D015995:Prevalence; D020521:Stroke / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors