title: Comparison of montreal cognitive assessment and mini-mental state examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage.
abstract: OBJECTIVE
  Cognitive deficits are common after aneurysmal subarachnoid haemorrhage (aSAH), and clinical evaluation is important for their management. Our hypothesis was that the Montreal Cognitive Assessment (MoCa) is superior to the Mini-Mental State Examination (MMSE) in screening for cognitive domain deficit in aSAH patients.
  
  
  METHODS
  We carried out a prospective observational and diagnostic accuracy study on Hong Kong aSAH patients aged 21 to 75 years who had been admitted within 96 hours of ictus. The domain-specific neuropsychological assessment battery, the MoCA and MMSE were administered 2-4 weeks and 1 year after ictus. A cognitive domain deficit was defined as a cognitive domain z score <-1.65 (below the fifth percentile). Cognitive impairment was defined as two or more cognitive domain deficits. The study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).
  
  
  RESULTS
  Both the MoCA and the MMSE were successful in differentiating between patients with and without cognitive domain deficits and cognitive impairment at both assessment periods. At 1 year post-ictus, the MoCA produced higher area under the curve scores for cognitive impairment than the MMSE (MoCA, 0.92; 95% CI, 0.83 to 0.97 versus MMSE, 0.77; 95% CI, 0.66 to 0.83, p = 0.009).
  
  
  CONCLUSIONS
  Cognitive domain deficits and cognitive impairment in patients with aSAH can be screened with the MoCA in both the subacute and chronic phases.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. georgewong@surgery.cuhk.edu.hk
authors.forename: George Kwok Chu
authors.initials: GK
authors.lastname: Wong
authors.forename: Sandy Wai
authors.initials: SW
authors.lastname: Lam
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Karine
authors.initials: K
authors.lastname: Ngai
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Poon
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
mesh_terms: D000368:Aged; D019540:Area Under Curve; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000473:pathology / Q000523:psychology*