Comparative study of two short-form versions of the montreal cognitive assessment for screening of post-stroke cognitive impairment in a Chinese population

Abstract

Purpose: Cognitive impairment (CI) is one of the most significant post-stroke complications. The Montreal Cognitive Assessment (MoCA) is widely applied to the early screening of post-stroke CI (PSCI), and has good sensitivity and specificity, but needs a long time to administer. Clinicians and researchers need shorter, more effective cognitive testing tools. The purpose of this study was to detect the sensitivity and specificity of two different shortform versions of the MoCA (SF-MoCA) for screening of PSCI in a Chinese population. Methods: A total of 2,989 stroke participants were included from 14 hospitals in northern and southern China between June 2011 and September 2013. The sensitivity and specificity of the two SF-MoCA versions were compared. Results: Using an MoCA score <26 as the critical value, the National Institute of Neurological Disease and Stroke–Canadian Stroke Network SF-MoCA showed sensitivity of 91% and specificity of 63% (PPV 71%, BPV 87%) with scores ≤10 points. The sensitivity and specificity of the Bocti SF-MoCA were 92% and 69% (PPV 75%, BPV 89%) with scores ≤7, respectively. The area under the curve was 0.885 (95% CI 0.873–0.897) and 0.912 (95% CI 0.902–0.922), respectively. Conclusion: The Bocti SF-MoCA can be used as a briefer and more effective screening tool for PSCI in Chinese.