title: Cognitive performance in asymptomatic patients with advanced carotid disease.
abstract: OBJECTIVE
  : In the absence of stroke or transient ischemic attack, patients with advanced carotid stenosis or occlusion (ICAs/o) are considered asymptomatic, yet they are prone to mostly subtle cognitive impairment.
  
  
  BACKGROUND
  : The Mini-Mental State Examination (MMSE) often fails to detect mild cognitive impairment. The Montreal Cognitive Assessment (MoCA) is more sensitive in recognizing such changes.
  
  
  METHODS
  : Scores on the MoCA and MMSE were compared in 70 asymptomatic patients with ICAs/o and 70 controls matched for demographic variables and vascular risk factors.
  
  
  RESULTS
  : MMSE scores fell mostly within the normal range in both patients and controls. Differences were significant for total MoCA scores (P<0.001). Patients with ICAs/o performed worse on visuospatial and executive function (P=0.018), abstraction (P<0.001), and delayed recall (P<0.001). Lower MoCA scores were associated with diabetes (odds ratio=6.41; 95% confidence interval, 1.277-32.220; P=0.024) and older age (odds ratio=0.86; 95% confidence interval, 0.780-0.956; P=0.004). Patients with diabetes performed worse on delayed recall (P<0.001), and patients with hypertension were worse on the MoCA naming subtest (P=0.04).
  
  
  CONCLUSIONS
  : The MoCA successfully identified reduced cognitive status in patients with ICAs/o. The MoCA subtest scores revealed a pattern of cognitive impairment similar to that documented in other studies using more extensive neuropsychological tests. MoCA could be used as part of the clinical evaluation of patients with ICAs/o.
authors.affiliation: University Department of Neurology, Sestre milosrdnice" University Hospital Centre, Zagreb, Croatia. irene@mail.inet.hr
authors.forename: Irena Martinic
authors.initials: IM
authors.lastname: Popovic
authors.forename: Arijana
authors.initials: A
authors.lastname: Lovrencic-Huzjan
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Simundic
authors.forename: Alek
authors.initials: A
authors.lastname: Popovic
authors.forename: Vesna
authors.initials: V
authors.lastname: Seric
authors.forename: Vida
authors.initials: V
authors.lastname: Demarin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002341:Carotid Artery Thrombosis / Q000150:complications / Q000523:psychology*; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology*; D003920:Diabetes Mellitus / Q000523:psychology*; D018618:Echocardiography, Doppler, Color / Q000379:methods / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D006973:Hypertension / Q000523:psychology; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000523:psychology