• S Horstmann, T Rizos, G Rauch, C Arden, and R Veltkamp.
• Department of Neurology, University of Heidelberg, Heidelberg, Germany.
• Eur. J. Neurol. 2014 Nov 1; 21 (11): 1387-93.

Background And PurposeCognitive deficits are common following stroke. Cognitive function in the acute stroke setting is a predictive factor for mid-term outcome. The Montreal Cognitive Assessment (MoCA) is a screening tool for cognitive impairment. The feasibility of MoCA in the acute phase of stroke was evaluated and factors predictive of cognitive impairment were determined.MethodsIn this prospective, single-centre, explorative and observational study consecutive patients with ischaemic (IS) or haemorrhagic (ICH) stroke were enrolled between March 2011 and September 2012. The routine work-up for each patient encompassed assessment of cardiovascular risk factors, the National Institutes of Health Stroke Scale (NIHSS) and the pre-morbid modified Rankin Scale (mRS) score. Cognitive performance was measured using the German version of the MoCA within the first days of admission. A MoCA score of <26 was considered to indicate cognitive impairment.ResultsBetween March 2011 and September 2012 a total of 842 patients with IS (89.0%) and ICH (11.0%) were enrolled in our study. MoCA was feasible in 678/842 patients (80.5%). Factors independently associated with non-feasibility were stroke severity (NIHSS), pre-morbid functional status (mRS), age and lower educational level. Mean MoCA was 21.4 (SD 5.7). A total of 498/678 (73.5%) patients appeared cognitively impaired (<26/30). Independent predictive factors for a lower MoCA score were age, educational level, stroke severity (NIHSS) and pre-morbid functional status (mRS).ConclusionsIn the acute phase of stroke, MoCA is feasible in about 80% of eligible patients. At this stage, MoCA identifies a cognitive impairment in 75% of patients.© 2014 The Author(s) European Journal of Neurology © 2014 EAN.

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