The Application Of Montreal Cotive Assessment In Screening Acute Post -stroke Cognitive Impairment

Objective:To explore the application of Montreal cotive assessment in screening acute post -stroke cognitive impairmentMethods:132 cases of acute cerebral infarction patients and 85 healthy age-matched subjects were selected. All subjects were examined with Mini-mental State Examination(MMSE), Montreal Cotive Assessment(MoCA), Modified Rankin Scale(MRS) and HamiltonDepression Scale (HAMD). Patients and control subjects were examined with CT and MRI. All subjects'general data also were collected.Results:(1) Totle scores of MoCA were correlated with that of MMSE, (ACI group r=0.847 ,p<0.01;Control group r=0.779, p<0.01); The scores of MoCA's subitems were correlated with totle scores of MoCA; The totle scores of MMSE in acute cerebral infarction were lower than the control group., (22.87±4.12vs27.23±3.55) ; The totle scores of MoCA in acute cerebral infarction were lower than the Control group(19.33±4.27vs24.63±4.31); Some sub-item score of MoCA in acute cerebral infarction were lower than the control group. In particular the score of Visuopatial/Executive , Abstraction subitem, Delayed recall and Orientation were lower than the control group.(p<0.05)(2) In the ACI group, MoCA and MMSE totle scores of the patients with over junior high school were higher than that of the patients with below junior high school(p<0.05); In the Control group, MoCA totle scores of the patients with over junior high school were higher than that of the patients with below junior high school(p<0.05)(3) For MoCA and MMSE , the Abnormality rate in patients with macroangiopathy was higher than those with Small vessels pathologica(p<0.05); The scores of MoCA and MMSE in patients with cerebral ganglion infarction and mix infarction were lower than those with other position infarction (p<0.05); The Visuopatial/Executive ability were mainly damaged in VCI.(4)The man who have three Vascular risk factors ,there MoCA and MMSE totle scores were lower than other who have only one Vascular risk factor(p<0.05); For the man with hypertension and smoking, the MoCA and MMSE totle scores were lower than other with hypertension and diabetes mellitus, hypertension and hyperlipemia(p<0.05); past stroke case history was best correlate with PSCI(bj= 0.912)Conclusions:(1)There was a high occurrence rate of post-stroke cognitive impairment in acute stage. The Visuopatial and Exeeutive function were injured commonly.(2)Level of education has an obvious impact to the cognitive assessment(3)The sensitivity of MoCA is higher than that of MMSE in screening the VCI from patients in acute stroke stage.