MoCA-assessed cognitive function and excellent outcome after aneurysmal subarachnoid hemorrhage at 1 year.
OBJECTIVE
After aneurysmal subarachnoid hemorrhage (aSAH), cognitive impairment, even mild and relatively isolated, can be devastating, especially in working-age persons. The Montreal Cognitive Assessment (MoCA) is accepted as a valid screening tool for mild cognitive impairment due to cerebral ischaemia. Whether MoCA is independently associated with excellent outcome [a score of 0 on the modified Rankin Scale (mRS) or 18/18 on the Lawton Instrumental Activities of Daily Living (IADL) scale] 1 year after aSAH was assessed.


METHODS
Hong Kong Chinese aSAH patients were assessed prospectively by means of the MoCA, Mini-Mental State Examination (MMSE), mRS and IADL scale at 1 year. This multicenter prospective observational study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).


RESULTS
In all, 194 patients completed the assessments at 1 year. After adjustment for age, both excellent IADL and mRS outcomes were associated with MoCA (OR 1.2, 95% CI 1.1-1.3, P < 0.001, and OR 1.1, 95% CI 1.0-1.2, P = 0.001, respectively).


CONCLUSIONS
MoCA-assessed cognitive function is an important determinant for excellent outcomes after aSAH.
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
G K C
GK
Wong
S W
SW
Lam
A
A
Wong
M
M
Lai
D
D
Siu
W S
WS
Poon
V
V
Mok
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D012372:ROC Curve; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000523:psychology; D055815:Young Adult
Mini-Mental State Examination; Montreal Cognitive Assessment; cerebral aneurysm; cognition; subarachnoid hemorrhage