title: Decline in changing Montreal Cognitive Assessment (MoCA) scores is associated with post-stroke cognitive decline determined by a formal neuropsychological evaluation.
abstract: OBJECTIVE
  We aimed to examine changes in the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores within a one-year period after stroke/transient ischemic attack (TIA) in associating cognitive decline determined by a formal neuropsychological test battery.
  
  
  METHODS
  Patients with ischemic stroke/TIA received MoCA and MMSE at baseline within 14 days after stroke/TIA, at 3-6 months and 1-year follow-ups. The scores of MoCA and MMSE were considered to have declined if there were a reduction of ≥2 points in the respective scores measured across two time points. The decline in neuropsychological diagnosis transitional status was defined by a category transition from no cognitive impairment or any cognitive impairment to a more severe cognitive impairment or dementia.
  
  
  RESULTS
  275 patients with a mean age of 59.8 ± 11.6 years, and education of 7.7 ± 4.3 years completed all the assessments at baseline, 3-6 months and 1-year follow-ups. A decline in MoCA scores from 3-6 months to 1 year was associated with higher risk of decline in diagnosis transitional status (odd ratio = 3.21, p = 0.004) in the same time period whereas there was no association with a decline in MMSE scores.
  
  
  CONCLUSIONS
  The decline in MoCA scores from 3-6 months to 1 year after stroke/TIA has three times higher risk for decline in the diagnosis transitional status. The decline of MoCA scores (reduction ≥ 2points) is associated with the decline in neuropsychological diagnosis transitional status.
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Hui Hui
authors.initials: HH
authors.lastname: Tan
authors.affiliation: Singapore Clinical Research Institute, Singapore.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Hock Luen
authors.initials: HL
authors.lastname: Teoh
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Bernard Poon-Lap
authors.initials: BP
authors.lastname: Chan
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Raymond Chee Seong
authors.initials: RC
authors.lastname: Seet
authors.affiliation: Memory Ageing and Cognition Center, Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Singapore.|Neuroscience Centre, Raffles Hospital, Singapore.
authors.forename: Narayanaswarmy
authors.initials: N
authors.lastname: Venketasubramanian
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Vijay Kumar
authors.initials: VK
authors.lastname: Sharma
authors.affiliation: Memory Ageing and Cognition Center, Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Singapore.
authors.forename: Christopher Li-Hsian
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore.|Centre for Healthy Brain Ageing (CHeBA) and Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: YanHong
authors.initials: Y
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis / Q000209:etiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D020521:Stroke / Q000150:complications*