Objective To explore the features of cognitive impairment among patients with acute ischemic
stroke.
Methods In this prospective study, data were collected consecutively from 220 in-patients at
the Neurology Department of Guangzhou First People's Hospital from March 2011 to June 2012.
These patients were assessed with both Montreal Cognitive Assessment (MoCA) and Mini-Mental
State Examination (MMSE) at the day of enrollment. Simultaneously, a control group of 146
healthy individuals from matched background was also set up. Control subjects were enrolled from
community centers, physical examination center in our hospital and some of them were relatives of
the patients as well. The patients were classified into subgroups based on the total scores of MoCA
and MMSE, respectively. There are four subgroup: Group A (MMSE<26, MoCA 23) with 93
patients, Group B (the scores of MMSE are between 26~27, MoCA 23) with 36 patients, Group C
(MMSE 28, MOCA 23) with 24 patients, Group D (those with normal scores in both MMSE and MOCA) with 67 patients.
Results Patients scored less than the controls overall on both the MMSE (25.07±3.99 vs
27.73±1.89) and MoCA (17.70±5.77 vs 23.96±3.44), (P <0.05). There is no statistic difference
in the naming subtests of MoCA in the two groups (patient group 3[2, 3], control group 3[2, 3],
P =0.159). A comparison of the subtest scores of MoCA suggests that the subgroup A (visuospatial/
executive function [1{0, 2}], naming [2{1, 3}], recall [1{0, 2}], attention [3{2, 5}], language [0{0,
0}], abstraction [0{0, 1}], orientation [4{3, 5}]) and subgroup B (visuospatial/executive function
[1{1, 2}], naming [2{1, 3}], recall [2{0, 3}], attention [5{4, 6}], language [0{0, 0}], abstraction
[1{1, 2}], orientation [6{5, 6}]) have worse performances than the control group (visuospatial/
executive function [4{3, 5}], naming [3{2, 3}], recall [3{2, 4}], attention [6{5, 6}], language [2{1,
2}], abstraction [2{1, 2}], orientation [6{6, 6}]) (P <0.05), while subgroup C show decreased score
in visuospatial/executive function (2[1, 3.75]), language (0[0, 0]) and recall (2[1, 3]) (P <0.05).
Conclusion Patients with acute ischemic stroke suffered from cognitive impairment in all
subdomains of MoCA except naming. Visuospatial/executive function, language and recall
impairment are the main clinical features in patients with mild cognitive impairment who cannot be
recognized by MMSE.
