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Evaluating the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Exam (MMSE) for Cognitive Impairment Post Stroke

其他書名	A Validation Study Against the Cognistat
出版	School of Graduate and Postdoctoral Studies, University of Western Ontario, 2012
URL	http://books.google.com.hk/books?id=fXf_wQEACAAJ&hl=&source=gbs_api

註釋Objective. To identify the better of two commonly used screening tools for detecting probable cognitive impairment in stroke patients in a large regional rehabilitation hospital (Parkwood Hospital, London, Ontario). This was a validation study of the Mini-Mental State Exam (MMSE) and the Montreal Cognitive Assessment (MoCA), using the Cognistat, as the criterion or 'gold standard'. It was hypothesized that the MoCA is a superior screening instrument to the MMSE for the detection of cognitive impairment in stroke patients. Methods. The MMSE and the MoCA were administered by occupational therapists and the Cognistat was administered by the student investigator. A second Cognistat was administered by two occupational therapists for the reliability sub-study. Age was abstracted in a chart review and patients were asked their level of education. ROC curves, sensitivity, specificity, positive and negative predictive values and positive likelihood ratios were analyzed. Intraclass correlation coefficients and kappa statistics were also calculated. Results and Conclusion. The MMSE and the MoCA have relative strengths and weaknesses. The MoCA had a slightly better diagnostic accuracy than the MMSE and demonstrated to be the more sensitive tool. These results should be viewed with some caution due to the use of the Cognistat as the gold standard.