Value Of The Montreal Cognitive Assessment For The Detection Of Vascular Cognitive Impairment In Cerebral Small Vessel Disease

1. ObjectiveTo study the neuropsychological characteristics of cognitive function impairment in people with cerebral small vessel disease (SVD) and the validity of Montreal Cognitive Assessment (MoCA) in cognitive impairment caused by SVD. According to the ROC curve analyses to determine the best cutoff of MoCA for screening cognitive impairment in SVD.2. Patients and methodsChoosing one hundred and three patients who was treated in outpatient or inpatient in department of neurology,the affiliated hospital of medical college,qingdao university. All the patients were over fifty years old and confirmed by imaging. In the same time recording the basic conditions of the patients, such as smoking, drinking,blood pressure, lipid, glucose and so on. According to the diagnostic criteria,103 patients with SVD were divided into two groups, cognitive impairment group(n=62) and the control(n=41).The cognitive impairment were divided into two groups:vascular cognitive impairment no dementia(VCIND) and vascular dementia(VD).All the patients were assessed by MoCA and MMSE3. Results(1) No significant differences were found between the two groups on age, gender and education level (P>0.05).(2) The total scores of MoCA in the cognitive impairment group were significantly lower compared with that in control group. Except attention, significant differences in other sub-items of MoCA were found between the two groups (P<0.05).(3) Using MMSE only total score,memory and recollection have statistics difference between the normal and the cognitive impairment.(4) Except naming and abstract, there were significant differences between VCIND and VD.(5) According to the ROC curve analyses, the best cut off of the cognitive impairment caused by cerebral small vessel disease is 22/23. With the best cut-off score, MoCA can provide a sensitivity of 91.9% and a specificity of 95.1%,and it's better than MMSE. (6) The total scores of MoCA and MMSE were (18.08±3.16), (25.53±2.91) respectively in the cognitive impairment group. There was high correlation between the total scores of MoCA and MMSE by using spearman correlation coefficient(r=0.522,P =0).4. Conclusion(1) The patients with cerebral small vessel disease appearance widespread cognitive impairment.Besides common memory, recollection, and orientation force, the patient's abstracting and execution function also suffer impairment. But they were neglected easily because the patient's condition developed slowly., in order to take efficiently intervention study we should carry out nerve psychology screening earlier.(2) MoCA as a new scale for cognitive screening has high sensitivity and a specificity.This study show that the best cut off of MoCA for cognitive impairment screening caused by SVD is 22/23.