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 short-form 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.
Keywords: cognitive dysfunction, Montreal Cognitive Assessment, MoCA, stroke, sensitivity, specificity