MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Intervention
2.3. Assessment
- Executive Functioning: this cognitive domain is investigated by three tests: (a) an alternation task adapted from the trail-making B task, (b) phonemic fluency, (c) a verbal abstraction task;
- Attention: investigated with three tests: (a) serial backward subtraction, (b) letter detection by tapping, (c) forward/backward digit span task;
- Language: assessed through two tests: (a) naming of three images of low-familiarity animals, (b) repetition of two syntactically complex sentences;
- Visuospatial: composed of two tests: (a) three-dimension cube copy, (b) clock drawing task;
- Orientation: composed of a single task in which the patient is asked to answer specific questions over time and place;
- Memory: consisting of a single memory test composed of delayed recall of five nouns after approximately five minutes from a learning trial.
2.4. Procedure of Data Collection
2.5. Statistical Analyses
3. Results
3.1. Participants
3.2. Patterns of Cognitive Impairment
3.3. Domain-Specific Cognitive Predictors of Patients’ Global Cognitive Functioning at Baseline (T0), Discharge (T1), and Follow-Up (T2)
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Guzik, A.; Bushnell, C. Stroke Epidemiology and Risk Factor Management. Continuum 2017, 23, 15–39. [Google Scholar] [CrossRef] [PubMed]
- Barbay, M.; Diouf, M.; Roussel, M.; Godefroy, O.; GRECOGVASC Study Group. Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies. Dement. Geriatr. Cogn. Disord. 2018, 46, 322–334. [Google Scholar] [CrossRef] [PubMed]
- Sexton, E.; McLoughlin, A.; Williams, D.J.; Merriman, N.A.; Donnelly, N.; Rohde, D.; Hickey, A.; Wren, M.-A.; Bennett, K. Systematic Review and Meta-Analysis of the Prevalence of Cognitive Impairment No Dementia in the First Year Post-Stroke. Eur. Stroke J. 2019, 4, 160–171. [Google Scholar] [CrossRef] [PubMed]
- Barker-Collo, S.; Feigin, V. The Impact of Neuropsychological Deficits on Functional Stroke Outcomes. Neuropsychol. Rev. 2006, 16, 53–64. [Google Scholar] [CrossRef] [PubMed]
- Achten, D.; Visser-Meily, J.M.A.; Post, M.W.M.; Schepers, V.P.M. Life Satisfaction of Couples 3 Years after Stroke. Disabil. Rehabil. 2012, 34, 1468–1472. [Google Scholar] [CrossRef] [PubMed]
- Delavaran, H.; Jönsson, A.-C.; Lövkvist, H.; Iwarsson, S.; Elmståhl, S.; Norrving, B.; Lindgren, A. Cognitive Function in Stroke Survivors: A 10-Year Follow-up Study. Acta Neurol. Scand. 2017, 136, 187–194. [Google Scholar] [CrossRef]
- Shi, D.; Chen, X.; Li, Z. Diagnostic Test Accuracy of the Montreal Cognitive Assessment in the Detection of Post-Stroke Cognitive Impairment under Different Stages and Cutoffs: A Systematic Review and Meta-Analysis. Neurol. Sci. 2018, 39, 705–716. [Google Scholar] [CrossRef]
- Pasi, M.; Poggesi, A.; Salvadori, E.; Pantoni, L. Post-Stroke Dementia and Cognitive Impairment. Front. Neurol. Neurosci. 2012, 30, 65–69. [Google Scholar] [CrossRef]
- Rost, N.S.; Brodtmann, A.; Pase, M.P.; van Veluw, S.J.; Biffi, A.; Duering, M.; Hinman, J.D.; Dichgans, M. Post-Stroke Cognitive Impairment and Dementia. Circ. Res. 2022, 130, 1252–1271. [Google Scholar] [CrossRef]
- Pantoni, L.; Salvadori, E. Location of Infarcts and Post-Stroke Cognitive Impairment. Lancet Neurol. 2021, 20, 413–414. [Google Scholar] [CrossRef]
- Nasreddine, Z.S.; Phillips, N.A.; Bédirian, V.; Charbonneau, S.; Whitehead, V.; Collin, I.; Cummings, J.L.; Chertkow, H. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment. J. Am. Geriatr. Soc. 2005, 53, 695–699. [Google Scholar] [CrossRef] [PubMed]
- Wu, C.-Y.; Hung, S.-J.; Lin, K.-C.; Chen, K.-H.; Chen, P.; Tsay, P.-K. Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation. Occup. Ther. Int. 2019, 2019, 2517658. [Google Scholar] [CrossRef] [PubMed]
- Potocnik, J.; Ovcar Stante, K.; Rakusa, M. The Validity of the Montreal Cognitive Assessment (MoCA) for the Screening of Vascular Cognitive Impairment after Ischemic Stroke. Acta Neurol. Belg. 2020, 120, 681–685. [Google Scholar] [CrossRef] [PubMed]
- Wong, A.; Xiong, Y.Y.; Kwan, P.W.L.; Chan, A.Y.Y.; Lam, W.W.M.; Wang, K.; Chu, W.C.W.; Nyenhuis, D.L.; Nasreddine, Z.; Wong, L.K.S.; et al. The Validity, Reliability and Clinical Utility of the Hong Kong Montreal Cognitive Assessment (HK-MoCA) in Patients with Cerebral Small Vessel Disease. Dement. Geriatr. Cogn. Disord. 2009, 28, 81–87. [Google Scholar] [CrossRef] [PubMed]
- Abzhandadze, T.; Rafsten, L.; Lundgren Nilsson, Å.; Palstam, A.; Sunnerhagen, K.S. Very Early MoCA Can Predict Functional Dependence at 3 Months After Stroke: A Longitudinal, Cohort Study. Front. Neurol. 2019, 10, 1051. [Google Scholar] [CrossRef] [PubMed]
- Verdelho, A.; Biessels, G.J.; Chabriat, H.; Charidimou, A.; Duering, M.; Godefroy, O.; Pantoni, L.; Pavlovic, A.; Wardlaw, J. Cerebrovascular Disease in Patients with Cognitive Impairment: A White Paper from the ESO Dementia Committee—A Practical Point of View with Suggestions for the Management of Cerebrovascular Diseases in Memory Clinics. Eur. Stroke J. 2021, 6, 111–119. [Google Scholar] [CrossRef] [PubMed]
- Folstein, M.F.; Folstein, S.E.; McHugh, P.R. “Mini-Mental State”. A Practical Method for Grading the Cognitive State of Patients for the Clinician. J. Psychiatr. Res. 1975, 12, 189–198. [Google Scholar] [CrossRef]
- Siciliano, M.; Chiorri, C.; Passaniti, C.; Sant’Elia, V.; Trojano, L.; Santangelo, G. Comparison of Alternate and Original Forms of the Montreal Cognitive Assessment (MoCA): An Italian Normative Study. Neurol. Sci. 2019, 40, 691–702. [Google Scholar] [CrossRef]
- Block, C.K.; Johnson-Greene, D.; Pliskin, N.; Boake, C. Discriminating Cognitive Screening and Cognitive Testing from Neuropsychological Assessment: Implications for Professional Practice. Clin. Neuropsychol. 2017, 31, 487–500. [Google Scholar] [CrossRef]
- Mole, J.A.; Demeyere, N. The Relationship between Early Post-Stroke Cognition and Longer Term Activities and Participation: A Systematic Review. Neuropsychol. Rehabil. 2020, 30, 346–370. [Google Scholar] [CrossRef]
- Turunen, K.E.A.; Laari, S.P.K.; Kauranen, T.V.; Uimonen, J.; Mustanoja, S.; Tatlisumak, T.; Poutiainen, E. Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up. J. Int. Neuropsychol. Soc. 2018, 24, 117–127. [Google Scholar] [CrossRef] [PubMed]
- Hurford, R.; Charidimou, A.; Fox, Z.; Cipolotti, L.; Werring, D.J. Domain-Specific Trends in Cognitive Impairment after Acute Ischaemic Stroke. J. Neurol. 2013, 260, 237–241. [Google Scholar] [CrossRef] [PubMed]
- Nys, G.M.S.; van Zandvoort, M.J.E.; de Kort, P.L.M.; van der Worp, H.B.; Jansen, B.P.W.; Algra, A.; de Haan, E.H.F.; Kappelle, L.J. The Prognostic Value of Domain-Specific Cognitive Abilities in Acute First-Ever Stroke. Neurology 2005, 64, 821–827. [Google Scholar] [CrossRef] [PubMed]
- Milosevich, E.T.; Moore, M.J.; Pendlebury, S.T.; Demeyere, N. Domain-Specific Cognitive Impairment 6 Months after Stroke: The Value of Early Cognitive Screening. Int. J. Stroke 2023, 14, 17474930231205788. [Google Scholar] [CrossRef] [PubMed]
- Delgado, J.; Masoli, J.; Hase, Y.; Akinyemi, R.; Ballard, C.; Kalaria, R.N.; Allan, L.M. Trajectories of Cognitive Change Following Stroke: Stepwise Decline towards Dementia in the Elderly. Brain Commun. 2022, 4, fcac129. [Google Scholar] [CrossRef]
- Tang, E.Y.; Amiesimaka, O.; Harrison, S.L.; Green, E.; Price, C.; Robinson, L.; Siervo, M.; Stephan, B.C. Longitudinal Effect of Stroke on Cognition: A Systematic Review. J. Am. Heart Assoc. 2018, 7, e006443. [Google Scholar] [CrossRef]
- Aam, S.; Einstad, M.S.; Munthe-Kaas, R.; Lydersen, S.; Ihle-Hansen, H.; Knapskog, A.-B.; Ellekjær, H.; Seljeseth, Y.; Saltvedt, I. Post-Stroke Cognitive Impairment-Impact of Follow-Up Time and Stroke Subtype on Severity and Cognitive Profile: The Nor-COAST Study. Front. Neurol. 2020, 11, 699. [Google Scholar] [CrossRef]
- Dharmasaroja, P.A. Temporal Changes in Cognitive Function in Early Recovery Phase of the Stroke. J. Stroke Cerebrovasc. Dis. 2021, 30, 106027. [Google Scholar] [CrossRef]
- Hakiki, B.; Paperini, A.; Castagnoli, C.; Hochleitner, I.; Verdesca, S.; Grippo, A.; Scarpino, M.; Maiorelli, A.; Mosca, I.E.; Gemignani, P.; et al. Predictors of Function, Activity, and Participation of Stroke Patients Undergoing Intensive Rehabilitation: A Multicenter Prospective Observational Study Protocol. Front. Neurol. 2021, 12, 632672. [Google Scholar] [CrossRef]
- von Elm, E.; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P.; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. J. Clin. Epidemiol. 2008, 61, 344–349. [Google Scholar] [CrossRef]
- Winstein, C.J.; Stein, J.; Arena, R.; Bates, B.; Cherney, L.R.; Cramer, S.C.; Deruyter, F.; Eng, J.J.; Fisher, B.; Harvey, R.L.; et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 2016, 47, e98–e169. [Google Scholar] [CrossRef] [PubMed]
- Cecchi, F.; Diverio, M.; Arienti, C.; Corbella, E.; Marrazzo, F.; Speranza, G.; Del Zotto, E.; Poggianti, G.; Gigliotti, F.; Polcaro, P.; et al. Development and Implementation of a Stroke Rehabilitation Integrated Care Pathway in an Italian No Profit Institution: An Observational Study. Eur. J. Phys. Rehabil. Med. 2020, 56, 713–724. [Google Scholar] [CrossRef] [PubMed]
- Aiello, E.N.; Gramegna, C.; Esposito, A.; Gazzaniga, V.; Zago, S.; Difonzo, T.; Maddaluno, O.; Appollonio, I.; Bolognini, N. The Montreal Cognitive Assessment (MoCA): Updated Norms and Psychometric Insights into Adaptive Testing from Healthy Individuals in Northern Italy. Aging Clin. Exp. Res. 2022, 34, 375–382. [Google Scholar] [CrossRef] [PubMed]
- Pendlebury, S.T.; Welch, S.J.V.; Cuthbertson, F.C.; Mariz, J.; Mehta, Z.; Rothwell, P.M. Telephone Assessment of Cognition after Transient Ischemic Attack and Stroke: Modified Telephone Interview of Cognitive Status and Telephone Montreal Cognitive Assessment versus Face-to-Face Montreal Cognitive Assessment and Neuropsychological Battery. Stroke 2013, 44, 227–229. [Google Scholar] [CrossRef] [PubMed]
- Santangelo, G.; Siciliano, M.; Pedone, R.; Vitale, C.; Falco, F.; Bisogno, R.; Siano, P.; Barone, P.; Grossi, D.; Santangelo, F.; et al. Normative Data for the Montreal Cognitive Assessment in an Italian Population Sample. Neurol. Sci. 2015, 36, 585–591. [Google Scholar] [CrossRef] [PubMed]
- Capitani, E.; Laiacona, M. Composite Neuropsychological Batteries and Demographic Correction: Standardization Based on Equivalent Scores, with a Review of Published Data. The Italian Group for the Neuropsychological Study of Ageing. J. Clin. Exp. Neuropsychol. 1997, 19, 795–809. [Google Scholar] [CrossRef]
- Appelros, P.; Karlsson, G.M.; Seiger, A.; Nydevik, I. Neglect and Anosognosia after First-Ever Stroke: Incidence and Relationship to Disability. J. Rehabil. Med. 2002, 34, 215–220. [Google Scholar] [CrossRef]
- Nijboer, T.C.W.; Kollen, B.J.; Kwakkel, G. Time Course of Visuospatial Neglect Early after Stroke: A Longitudinal Cohort Study. Cortex 2013, 49, 2021–2027. [Google Scholar] [CrossRef]
- Demeyere, N.; Riddoch, M.J.; Slavkova, E.D.; Bickerton, W.-L.; Humphreys, G.W. The Oxford Cognitive Screen (OCS): Validation of a Stroke-Specific Short Cognitive Screening Tool. Psychol. Assess. 2015, 27, 883–894. [Google Scholar] [CrossRef]
- Pedersen, P.M.; Jørgensen, H.S.; Nakayama, H.; Raaschou, H.O.; Olsen, T.S. Orientation in the Acute and Chronic Stroke Patient: Impact on ADL and Social Activities. The Copenhagen Stroke Study. Arch. Phys. Med. Rehabil. 1996, 77, 336–339. [Google Scholar] [CrossRef]
- Rehabilitation and Recovery of People with Aphasia after Stroke (RELEASE) Collaborators. Predictors of Poststroke Aphasia Recovery: A Systematic Review-Informed Individual Participant Data Meta-Analysis. Stroke 2021, 52, 1778–1787. [Google Scholar] [CrossRef] [PubMed]
- Pedersen, P.; Jørgensen, H.; Nakayama, H.; Raaschou, H.; Olsen, T. Impaired Orientation in Acute Stroke: Frequency, Determinants, and Time-Course of Recovery. Cerebrovasc. Dis. 1998, 8, 90–96. [Google Scholar] [CrossRef] [PubMed]
- Oh, H.; Park, J.; Seo, W. A 2-Year Prospective Follow-up Study of Temporal Changes Associated with Post-Stroke Cognitive Impairment. Int. J. Nurs. Pract. 2018, 24, e12618. [Google Scholar] [CrossRef] [PubMed]
- Oh, H.S.; Park, W.; Kwon, S.R.; Lim, M.J.; Suh, Y.O.; Seo, W.S.; Park, J.S. Effects of gout web based self-management program on knowledge related to disease, medication adherence, and self-management. J. Korean Acad. Nurs. 2013, 43, 547–556. [Google Scholar] [CrossRef] [PubMed]
- Berthier, M.L. Poststroke Aphasia: Epidemiology, Pathophysiology and Treatment. Drugs Aging 2005, 22, 163–182. [Google Scholar] [CrossRef] [PubMed]
- Harvey, R.L. Predictors of Functional Outcome Following Stroke. Phys. Med. Rehabil. Clin. N. Am. 2015, 26, 583–598. [Google Scholar] [CrossRef] [PubMed]
- Buxbaum, L.J.; Ferraro, M.K.; Veramonti, T.; Farne, A.; Whyte, J.; Ladavas, E.; Frassinetti, F.; Coslett, H.B. Hemispatial Neglect: Subtypes, Neuroanatomy, and Disability. Neurology 2004, 62, 749–756. [Google Scholar] [CrossRef]
- Katz, N.; Hartman-Maeir, A.; Ring, H.; Soroker, N. Functional Disability and Rehabilitation Outcome in Right Hemisphere Damaged Patients with and without Unilateral Spatial Neglect. Arch. Phys. Med. Rehabil. 1999, 80, 379–384. [Google Scholar] [CrossRef]
- Esposito, E.; Shekhtman, G.; Chen, P. Prevalence of Spatial Neglect Post-Stroke: A Systematic Review. Ann. Phys. Rehabil. Med. 2021, 64, 101459. [Google Scholar] [CrossRef]
- Rasquin, S.M.C.; Lodder, J.; Ponds, R.W.H.M.; Winkens, I.; Jolles, J.; Verhey, F.R.J. Cognitive Functioning after Stroke: A One-Year Follow-up Study. Dement. Geriatr. Cogn. Disord. 2004, 18, 138–144. [Google Scholar] [CrossRef]
- Leśniak, M.; Bak, T.; Czepiel, W.; Seniów, J.; Członkowska, A. Frequency and Prognostic Value of Cognitive Disorders in Stroke Patients. Dement. Geriatr. Cogn. Disord. 2008, 26, 356–363. [Google Scholar] [CrossRef] [PubMed]
- Sinanović, O.; Mrkonjić, Z.; Zukić, S.; Vidović, M.; Imamović, K. Post-Stroke Language Disorders. Acta Clin. Croat. 2011, 50, 79–94. [Google Scholar] [PubMed]
- Chung, C.S.Y.; Pollock, A.; Campbell, T.; Durward, B.R.; Hagen, S. Cognitive Rehabilitation for Executive Dysfunction in Adults with Stroke or Other Adult Non-Progressive Acquired Brain Damage. Cochrane Database Syst. Rev. 2013, 2013, CD008391. [Google Scholar] [CrossRef] [PubMed]
- McDowd, J.M.; Filion, D.L.; Pohl, P.S.; Richards, L.G.; Stiers, W. Attentional Abilities and Functional Outcomes Following Stroke. J. Gerontol. B Psychol. Sci. Soc. Sci. 2003, 58, P45–P53. [Google Scholar] [CrossRef] [PubMed]
- Rowlands, L.; Coetzer, R.; Turnbull, O.H. Building the Bond: Predictors of the Alliance in Neurorehabilitation. NeuroRehabilitation 2020, 46, 271–285. [Google Scholar] [CrossRef]
- VanGilder, J.L.; Hooyman, A.; Peterson, D.S.; Schaefer, S.Y. Post-Stroke Cognitive Impairments and Responsiveness to Motor Rehabilitation: A Review. Curr. Phys. Med. Rehabil. Rep. 2020, 8, 461–468. [Google Scholar] [CrossRef]
- Stolwyk, R.J.; O’Neill, M.H.; McKay, A.J.D.; Wong, D.K. Are Cognitive Screening Tools Sensitive and Specific Enough for Use After Stroke? Stroke 2014, 45, 3129–3134. [Google Scholar] [CrossRef]
- Plummer, P.; Eskes, G.; Wallace, S.; Giuffrida, C.; Fraas, M.; Campbell, G.; Clifton, K.-L.; Skidmore, E.R.; American Congress of Rehabilitation Medicine Stroke Networking Group Cognition Task Force. Cognitive-Motor Interference during Functional Mobility after Stroke: State of the Science and Implications for Future Research. Arch. Phys. Med. Rehabil. 2013, 94, 2565–2574.e6. [Google Scholar] [CrossRef]
- Dong, Y.; Venketasubramanian, N.; Chan, B.P.-L.; Sharma, V.K.; Slavin, M.J.; Collinson, S.L.; Sachdev, P.; Chan, Y.H.; Chen, C.L.-H. Brief Screening Tests during Acute Admission in Patients with Mild Stroke Are Predictive of Vascular Cognitive Impairment 3–6 Months after Stroke. J. Neurol. Neurosurg. Psychiatry 2012, 83, 580–585. [Google Scholar] [CrossRef]
- Zietemann, V.; Georgakis, M.K.; Dondaine, T.; Müller, C.; Mendyk, A.-M.; Kopczak, A.; Hénon, H.; Bombois, S.; Wollenweber, F.A.; Bordet, R.; et al. Early MoCA Predicts Long-Term Cognitive and Functional Outcome and Mortality after Stroke. Neurology 2018, 91, e1838–e1850. [Google Scholar] [CrossRef]
- Bisogno, A.L.; Franco Novelletto, L.; Zangrossi, A.; De Pellegrin, S.; Facchini, S.; Basile, A.M.; Baracchini, C.; Corbetta, M. The Oxford Cognitive Screen (OCS) as an Acute Predictor of Long-Term Functional Outcome in a Prospective Sample of Stroke Patients. Cortex 2023, 166, 33–42. [Google Scholar] [CrossRef] [PubMed]
Variables | Median [IQR] or Frequencies At Admission (T0) | Median [IQR] or Frequencies At Discharge (T1) | Median [IQR] or Frequencies At Follow-Up (T2) | p-Value |
---|---|---|---|---|
Age (years) | 76.0 [16.0] | - | - | - |
Gender | Male: 35 (52.2%) Female: 32 (47.8%) | - | - | - |
Schooling | 8.00 [8.00] | - | - | - |
Time from the event (days) | 11.0 [9.00] | - | - | - |
Type of stroke | Ischemic: 49 (73.1%) Haemorrhagic: 18 (26.9%) | - | - | - |
Side of stroke | Right: 35 (52.2%) Left: 24 (35.8%) Bilateral: 6 (9.0%) | - | - | - |
Area of the lesion | None: 4 (6.0%) Supratentorial: 52 (77.6%) Subtentorial: 8 (11.9%) Both: 3 (4.5%) | - | - | - |
NIHSS score | 5.00 [6.00] | 2.00 [5.00] | - | <0.001 |
NIHSS item 9 (language) | No aphasia: 53 (79.1%) Mild to moderate aphasia: 9 (13.4%) Severe aphasia: 4 (6.0%) Mute or global aphasia: 0 (0%) | No aphasia: 56 (83.6%) Mild to moderate aphasia: 9 (13.4%) Severe aphasia: 1 (1.5%) Mute or global aphasia: 0 (0%) | No aphasia: 42 (62.7%) Mild to moderate aphasia: 6 (9.0%) Severe aphasia: 1 (1.5%) Mute or global aphasia: 0 (0%) | 0.028 |
mBI score | 37.0 [45.0] | 79.0 [46.0] | 93.0 [25.0] | <0.001 |
MoCA_dichotomised | Altered: 34 (50.7%) Normal: 33 (49.3%) | Altered: 12 (17.9%) Normal: 55 (82.1%) | Altered: 25 (37.3%) Normal: 42 (62.7%) | <0.001 |
Length of stay (days) | - | 32.0 [20.0] | - | - |
Speech therapy treatment | - | No: 25 (37.3%) Yes: 42 (62.7%) | - | - |
MoCA Subtests | Number of Altered Cases | p-Values of Pairwise Comparisons | p-Value | ||||
---|---|---|---|---|---|---|---|
T0 | T1 | T2 | T0-T1 | T0-T2 | T1-T2 | ||
Visuospatial | 18 (36.7%) | 5 (10.2%) | 8 (16.3%) | 0.001 | 0.012 | 1.000 | <0.001 |
Attention | 21 (42.9%) | 12 (24.5%) | 9 (18.4%) | 0.034 | 0.002 | 1.000 | 0.002 |
Language | 11 (22.4%) | 6 (12.2%) | 18 (36.7%) | 0.513 | 0.166 | 0.003 | 0.004 |
Repetition | 0: 10 (20.4%) 1: 15 (30.6%) 2: 24 (49.0%) | 0: 8 (16.3%) 1: 17 (34.7%) 2: 24 (49.0%) | 0: 7 (14.3%) 1: 12 (24.5%) 2: 30 (61.2%) | 0.090 | 0.090 | 0.107 | 0.172 |
Naming | 0: 0 (0%) 1: 2 (4.1%) 2: 6 (12.2%) 3: 41 (83.7%) | 0: 0 (0%) 1: 0 (0%) 2: 5 (10.2%) 3: 44 (89.8%) | 0: 0 (0%) 1: 4 (8.2%) 2: 7 (14.3%) 3: 38 (77.6%) | 0.003 | 0.302 | 0.003 | 0.031 |
Executive | 13 (26.5%) | 7 (14.3%) | 5 (10.2%) | 0.125 | 0.020 | 1.000 | 0.018 |
Memory (raw score) | 10 (20.4%) 1.0 [2.0] | - 2.0 [3.0] | - 1.0 [3.0] | - 0.043 | - 0.480 | - 0.189 | - 0.045 |
Orientation | 21 (42.9%) | 8 (16.3%) | 20 (40.8%) | 0.007 | 1.000 | 0.014 | 0.003 |
MoCA Subtests at T0 | Outcome: Dichotomised MoCA at T1 | ||
---|---|---|---|
0: Altered Cognitive Status (N = 12) | 1: Normal Cognitive Status (N = 55) | p-Value | |
Visuospatial | Altered: 9 (75.0%) Normal: 3 (25.0%) | Altered: 19 (34.5%) Normal: 36 (65.5%) | 0.021 |
Attention | Altered: 10 (83.3%) Normal: 2 (16.7%) | Altered: 23 (41.8%) Normal: 32 (58.2%) | 0.011 |
Language | Altered: 7 (58.3%) Normal: 5 (41.7%) | Altered: 8 (14.5%) Normal: 47 (85.5%) | 0.003 |
Executive | Altered: 10 (83.3%) Normal: 2 (16.7%) | Altered: 10 (18.2%) Normal: 45 (81.8%) | <0.001 |
Memory | Altered: 2 (16.7%) Normal: 10 (83.3%) | Altered: 10 (18.2%) Normal: 45 (81.8%) | 1.000 |
Orientation | Altered: 9 (75.0%) Normal: 3 (25.0%) | Altered: 26 (47.3%) Normal: 29 (52.7%) | 0.114 |
MoCA Subtests at T0 | Outcome: Dichotomised MoCA at T2 | ||
---|---|---|---|
0: Altered Cognitive Status (N = 25) | 1: Normal Cognitive Status (N = 42) | p-Value | |
Visuospatial | Altered: 14 (56.0%) Normal: 11 (44.0%) | Altered: 14 (33.3%) Normal: 28 (66.7%) | 0.080 |
Attention | Altered: 19 (76.0%) Normal: 6 (24.0%) | Altered: 14 (33.3%) Normal: 28 (66.7%) | 0.001 |
Language | Altered: 9 (36.0%) Normal: 16 (64.0%) | Altered: 6 (14.3%) Normal: 36 (85.7%) | 0.067 |
Executive | Altered: 14 (56.0%) Normal: 11 (44.0%) | Altered: 6 (14.3%) Normal: 36 (85.7%) | 0.001 |
Memory | Altered: 5 (20.0%) Normal: 20 (80.0%) | Altered: 7 (16.7%) Normal: 35 (83.3%) | 0.751 |
Orientation | Altered: 19 (76.0%) Normal: 6 (24.0%) | Altered: 16 (38.1%) Normal: 26 (61.9%) | 0.005 |
Steps | Independent Variables | B | Standard Error | Wald | p-Value | Exp(B) | 95% Confidence Interval | |
---|---|---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||||
1st step (Nagelkerke’s R2 = 0.537) | Visuospatial | −1.370 | 0.925 | 2.192 | 0.139 | 0.254 | 0.041 | 1.558 |
Attention | −0.921 | 1.004 | 0.842 | 0.359 | 0.398 | 0.056 | 2.847 | |
Language | −1.678 | 0.940 | 3.188 | 0.074 | 0.187 | 0.030 | 1.178 | |
Executive | −2.264 | 0.963 | 5.527 | 0.019 | 0.104 | 0.016 | 0.686 | |
Constant | 4.514 | 1.086 | 17.264 | 0.000 | 91.288 | - | - | |
2nd step (Nagelkerke’s R2 = 0.523) | Visuospatial | −1.274 | 0.900 | 2.002 | 0.157 | 0.280 | 0.048 | 1.633 |
Language | −1.897 | 0.893 | 4.510 | 0.034 | .150 | 0.026 | 0.864 | |
Executive | −2.576 | 0.917 | 7.892 | 0.005 | 0.076 | 0.013 | 0.459 | |
Constant | 4.146 | 0.962 | 18.566 | 0.000 | 63.209 | - | - | |
3rd step (Nagelkerke’s R2 = 0.487) | Language | −1.818 | 0.842 | 4.658 | 0.031 | 0.162 | 0.031 | 0.846 |
Executive | −2.936 | 0.890 | 10.883 | 0.001 | 0.053 | 0.009 | 0.304 | |
Constant | 3.639 | 0.832 | 19.129 | 0.000 | 38.035 | - | - |
Steps | Independent Variables | B | Standard Error | Wald | p-Value | Exp(B) | 95% Confidence Interval | |
---|---|---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||||
1st step (Nagelkerke’s R2 = 0.384) | Attention | −1.282 | 0.632 | 4.113 | 0.043 | 0.277 | 0.080 | 0.958 |
Executive | −1.528 | 0.649 | 5.543 | 0.019 | 0.217 | 0.061 | 0.774 | |
Orientation | −1.064 | 0.637 | 2.785 | 0.095 | 0.345 | 0.099 | 1.204 | |
Constant | 2.346 | 0.607 | 14.916 | 0.000 | 10.439 | - | - |
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Basagni, B.; Malloggi, S.; Polito, C.; Pellicciari, L.; Campagnini, S.; Pancani, S.; Mannini, A.; Gemignani, P.; Salvadori, E.; Marignani, S.; et al. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study. Behav. Sci. 2024, 14, 42. https://doi.org/10.3390/bs14010042
Basagni B, Malloggi S, Polito C, Pellicciari L, Campagnini S, Pancani S, Mannini A, Gemignani P, Salvadori E, Marignani S, et al. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study. Behavioral Sciences. 2024; 14(1):42. https://doi.org/10.3390/bs14010042
Chicago/Turabian StyleBasagni, Benedetta, Serena Malloggi, Cristina Polito, Leonardo Pellicciari, Silvia Campagnini, Silvia Pancani, Andrea Mannini, Paola Gemignani, Emilia Salvadori, Sara Marignani, and et al. 2024. "MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study" Behavioral Sciences 14, no. 1: 42. https://doi.org/10.3390/bs14010042