The Montreal Cognitive Assessment: Short Cognitive Evaluation in a Large Stroke Trial

Background and Purpose— Cognitive function is often ignored in stroke research trials. The brief Montreal Cognitive Assessment (MoCA) may be sensitive to stroke-related cognitive deficits. Methods— We evaluated the feasibility of administering the MoCA at 3 months in a large stroke trial (A Very Early Rehabilitation Trial [AVERT]). Results— Data (blinded to intervention group) are presented for 294 patients with mean age of 70.6 years (SD, 12.8); 220 (75%) completed the MoCA, 54 (18%) had missing data, and 20 (7%) had died. Of those surviving to 3 months, the MoCA was completed by 87% with mild stroke, 79% with moderate stroke, and 67% with severe stroke on admission. Mean MoCA score was 21.1 (SD 7.5) out of 30; only 78 of 220 (35%) patients attained the “normal” cutoff (≥26). Conclusions— The MoCA is a feasible global cognitive screening tool in stroke trials. Clinical Trial Registration— URL: www.anzctr.org.au/trial_view.aspx?ID=1266. Unique identifier: ACTRN12606000185561.

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