title: Cognitive screening in the acute stroke setting.
abstract: BACKGROUND
  current literature suggests that two-thirds of patients will have cognitive impairment at 3 months post-stroke. Post-stroke cognitive impairment is associated with impaired function and increased mortality. UK guidelines recommend all patients with stroke have a cognitive assessment within 6 weeks. There is no 'gold standard' cognitive screening tool. The Montreal cognitive assessment (MoCA) is more sensitive than the Mini-Mental State Examination (MMSE) in mild cognitive impairment and for cognitive impairment in the non-acute post-stroke setting and in a Chinese-speaking acute stroke setting.
  
  
  METHODS
  a convenience sample of 50 patients, admitted with stroke or transient ischaemic attack (TIA), were screened within 14 days, using the MoCA and the MMSE.
  
  
  RESULTS
  the mean MoCA was 21.80 versus a mean MMSE of 26.98; 70% were impaired on the MoCA (cut-off <26) versus 26% on MMSE (cut-off <27). The MoCA could be completed in <10 min in 90% of cases.
  
  
  CONCLUSIONS
  the MoCA is easy and quick to use in the acute stroke setting. Further work is required to determine whether a low score on the MoCA in the acute stroke setting will predict the cognitive and functional status and to explore what the best cut-off should be in an acute post-stroke setting.
authors.affiliation: Academic Neurology Unit, University of Sheffield, Sheffield Institute for Translational Neuroscience, 385a Glossop Road, Sheffield, S. Yorks S10 2HQ, UK. d.blackburn@shef.ac.uk
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Blackburn
authors.forename: Leila
authors.initials: L
authors.lastname: Bafadhel
authors.forename: Marc
authors.initials: M
authors.lastname: Randall
authors.forename: Kirsty A
authors.initials: KA
authors.lastname: Harkness
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D020521:Stroke / Q000523:psychology*