Comparison of the Mini‐Mental State Examination and Montreal Cognitive Assessment executive subtests in detecting post‐stroke cognitive impairment

Fu, Chen; Jin, Xin; Chen, Baoxin; Xue, Fengxia; Niu, Huanmin; Guo, R. S.; Chen, Zhigang; Hong, Zheng; Wang, Le; Zhang, Yunling

doi:10.1111/ggi.13069

Cited by 45 publications

(31 citation statements)

References 23 publications

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“…Most studies showed an improvement in memory and an increase in MMSE scores [33]. Our results are in line with these results; our study also shows that MOCA-K scores, which can reflect the frontal lobe function, are significantly higher than the scores of other scales and that this difference is higher in the intervention group than in the control group [34,35]. Sub-item analysis of MOCA-K scores showed that the improvement in the executive function and delayed memory was more prominent than that in other domains.…”

Section: Discussionsupporting

confidence: 92%

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

et al. 2020

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The effect of music therapy on cognitive function has been widely reported; however, its clinical implications remain controversial. Performing therapeutic musical activities in groups using individualized instruments can help overcome the issues of engagement and compliance. We aimed to evaluate the effect of a cognitive intervention with musical stimuli using digital devices on mild cognitive impairment (MCI). In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled. We developed an electronic device with musical instruments and the Song-based Cognitive Stimulation Therapy protocol (SongCST). Patients in the intervention group underwent a 10-week cognitive intervention involving musical stimuli generated by our device. Effect of the intervention on cognitive function was evaluated by the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Montreal Cognitive Assessment-Korean (MOCA-K), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). In the intervention group, MMSE-DS and MOCA-K scores improved significantly after the 10-week intervention. The changes in MOCA-K and CDR-SB scores were significantly different between the intervention and control groups. Our study showed that music therapy with digital devices has a positive effect on the executive function and overall disease severity in patients with MCI. Our study can facilitate individualization of music therapy using digital devices in groups.

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Section: Discussionsupporting

confidence: 92%

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

et al. 2020

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“…Studies suggest that the MMSE is an adequate screening instrument in a setting with a high prevalence of disorders resulting in severe cognitive impairment. It loses predictive value when cognitive disturbances are milder, less prevalent, and mainly occur in the executive domain, as seems to be the case in FD …”

Section: Discussionmentioning

confidence: 93%

“…29 Studies suggest that the MMSE is an adequate screening instrument in a setting with a high prevalence of disorders resulting in severe cognitive impairment. It loses predictive value when cognitive disturbances are milder, less prevalent, and mainly occur in the executive domain, [30][31][32] as seems to be the case in FD. 5,6 This is, to our knowledge, the first study on the accuracy and effectiveness of using a cognitive screening instrument in a FD population.…”

Section: Discussionmentioning

confidence: 98%

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The Mini Mental State Examination does not accurately screen for objective cognitive impairment in Fabry Disease

et al. 2019

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Fabry disease (FD) patients may suffer from objective cognitive impairment (OCI). This study assessed the accuracy of the Mini Mental State Examination (MMSE) to screen for OCI in FD patients. Presence or absence of OCI was established using a neuropsychological test battery. For different MMSE cutoffs sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index (CUI) to identify OCI were calculated. Eighty‐one patients were included (mean age 44.5 ± 14.3, 35% men, 74% classical phenotype) of which 13 patients (16%) had OCI. The median MMSE score was 29 (range: 25‐30). MMSE cutoffs ≤28 and ≤29 had the highest sensitivity and specificity, with higher specificity reached at cutoff ≤28 (sensitivity: .46, specificity: .73) and higher sensitivity at cutoff ≤29 (sensitivity: .92, specificity: .40). PPV was low for both cutoffs (PPV ≤28: .25, PPV ≤29: .23) resulting in a low positive CUI (case finding ability). The results of our study indicate that the MMSE does not accurately screen for OCI in FD, with poor sensitivity‐specificity trade‐off at all cutoffs. The low PPV shows that the majority of FD patients that score below the cutoffs do not suffer from OCI. Administering the MMSE as a screening test will lead to unnecessary referrals for neuropsychological testing, which is time consuming and burdensome. Screening tools designed to accurately detect mild (executive) impairment might prove more appropriate to screen for OCI in FD.

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“…Most studies have shown overreliance on the Mini-Mental State Examination (MMSE) to measure cognitive function [31], which may limit the possibility of detecting minor cognitive change in various domains. The MMSE has a poor sensitivity for distinguishing mild cognitive impairment due to the insufficient complexity and executive function items [31,37,38]. Compared to the MMSE, the Montreal Cognitive Assessment (MoCA) instrument is a more challenging test that includes higher-level language as well as more complex executive function and visual-spatial processing to enable detection of mild impairment [39,40,41,42].…”

Section: Knowledge Gaps and Recommendations For Future Studiesmentioning

confidence: 99%

Vascular Aging and Cognitive Dysfunction: Silent Midlife Crisis in the Brain

Lin¹,

Cheng²,

Chuang

et al. 2017

Pulse

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Background: Vascular aging may cause cerebral microvascular damage and cognitive dysfunction. There is incremental evidence that consistently implicates arterial stiffness being involved in the manifestation of cognitive impairment in the elderly. However, few investigations have examined the relationship between arterial stiffness and cognitive impairment in midlife. Summary: Past studies inconsistently showed improved cognitive outcomes after antihypertensive therapy in elderly populations. Nevertheless, recent findings revealed that blood-pressure-lowering treatment in young adults might eliminate or halt the progression of the detrimental effects related to arterial stiffness, indicating that younger adults may have more favorable outcomes in cognition than their older counterparts if early intervention is conducted at the subclinical stage. Stiffening of the aorta may lead to an excessive flow pulsatility in the brain that may cause microvascular structural brain damage and worse cognitive performance. Recent investigations have suggested that arterial stiffness is likely to trigger initial silent brain damage, possibly preceding midlife, while the manifestation of cognitive decline and deterioration can be foreseen in the subsequent life span. Key Message: Despite the recent novel findings, definite conclusions on causality between vascular aging and cognitive dysfunction cannot be drawn at present. Further well-powered longitudinal studies with superior neuroimaging indicator, vascular mechanical biomarkers, and sensitive cognitive assessment tools that examine a broad range of age populations may help extend our understanding of the association between vascular aging and cognitive dysfunction throughout the life span.

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Comparison of the Mini‐Mental State Examination and Montreal Cognitive Assessment executive subtests in detecting post‐stroke cognitive impairment

Abstract: The MoCA executive tasks are more sensitive in detecting executive dysfunction compared with the MMSE executive tasks. Geriatr Gerontol Int 2017; 17: 2329-2335.

Cited by 45 publications

References 23 publications

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

The Mini Mental State Examination does not accurately screen for objective cognitive impairment in Fabry Disease

Vascular Aging and Cognitive Dysfunction: Silent Midlife Crisis in the Brain

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