The montreal cognitive assessment and mini-mental state examination visuoexecutive subtests in acute ischemic stroke patients and their correlations with demographic and clinical factors

Acta Neurol Belg. 2021 Dec;121(6):1707-1714. doi: 10.1007/s13760-020-01479-z. Epub 2020 Nov 21.

Abstract

Visuoexecutive impairment is common among acute ischemic stroke patients. This study aimed to examine the ability of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) visuoexecutive subtests to detect visuoexecutive abnormality in acute ischemic stroke patients and to identify the predictors for their impairments. 336 patients who completed the MMSE and MoCA were enrolled in this study. We compared the proportion of participants with incorrect MoCA visuoexecutive tasks and MMSE pentagon copying. Multivariate logistic regression analysis was used to evaluate the associations between the visuoexecutive dysfunction and demographic and clinical characteristics in the samples. Among all the participants, the MoCA detected more visuoexecutive dysfunction than the MMSE (88.69% vs. 45.83%, respectively; p < 0.001). The predictors identified by the univariate analysis included the factors of gender, age, educational level, smoking, alcohol consumption, Oxfordshire Community Stroke Project (OCSP), previous strokes, initial NIHSS score and number of old lacunar infarctions, while from the multivariate logistic regression analysis, the factors of age, educational level, NIHSS score, previous strokes and number of old lacunar infarctions served as predictive factors for the visuoexecutive impairment in acute stroke patients. In conclusion, visuoexecutive impairment is associated with the factors of the educational level, stroke severity, stroke history and number of old lacunar infarctions. Our findings may guide the clinicians to intervene the risks for the patients at an early stage after stroke and form the basis for good rehabilitation plans.

Keywords: Acute ischemic stroke; Cognitive impairment; MMSE; MoCA; Visuoexecutive function.

MeSH terms

  • Aged
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / psychology*
  • Brief Psychiatric Rating Scale*
  • Cognitive Dysfunction / diagnostic imaging
  • Cognitive Dysfunction / psychology*
  • Cohort Studies
  • Executive Function / physiology*
  • Female
  • Humans
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / psychology*
  • Male
  • Mental Status and Dementia Tests*
  • Middle Aged
  • Visual Perception / physiology