The validity of the Montreal cognitive assessment (MoCA) for the screening of vascular cognitive impairment after ischemic stroke

Vascular cognitive impairment (VCI) is a common feature of vascular brain lesions. The heterogeneity of clinical presentation after a stroke makes it challenging to find. However, the Montreal Cognitive Assessment Scale (MoCA) may be suitable for such purpose. Aim of the present study was to validate the Slovenian version of MoCA for detecting cognitive impairment after ischemic stroke. Seventy patients up to three months after ischemic stroke and 69 age-matched healthy control were included. All performed the MoCA and Hachinski Ischemic Scale (HIS). Cut-off value, sensitivity, specificity and likelihood ratio of MoCA were calculated with the receiver operating characteristic curve. Mean age of healthy controls was 67.1 (SD 9.2) years, mean MoCA was 25.8 (SD 2.6) points, and mean HIS was [1.9 (SD 1.5). There were no age differences between healthy controls and patients [70.4 (SD 10.9) years]. However, patients performed significantly worse on MoCA [mean 18.7 (SD 6.3) points) and had higher HIS score (7.6 (SD 0.3) points]. Optimal cut-off values for MoCA were 24/25 points. The area under the curve was 0.86, sensitivity was 81%, and specificity was 70%. A negative correlation was found between MoCA and education and age. Our results demonstrate that an optimal cut-off for screening for VCI in the Slovenian population is 24/25 points on MoCA, which is similar to other studies performed on patients with different cultural background. The test is easy to perform and could be used in daily clinical practice.