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Cognitive outcome after stroke

Dr Catherine Yanhong Dong, Prof Perminder Sachdev
Research Centre DCRC Assessment and Better Care
Partner Institution Centre-based
Project Description

The initial aim of this project was to establish a sensitive cognitive screening instrument for VCI by comparing the discriminatory ability of the new instrument, the Montreal Cognitive Assessment (MoCA) with the widely used conventional test, the Mini-Mental State Examination (MMSE).

400 patients with stroke and Transient Ischemic Attack were recruited over 2 years and followed up from subacute stroke phase (initial 2 weeks) to 3-6 months later. Patients received the MoCA, MMSE at baseline and 3-6 months after stroke. In addition, these patents were administered a formal neuropsychological battery at 3-6 months later.

We have established that both MoCA and MMSE administered at subacute stroke phase can detect significant VCI at 3-6 months later. We also improved the VCI screening by supplementing the MoCA and MMSE with a processing speed test, the Symbol Digit Modalities Test.

In addition to achieving the initial aims, this project has developed 3 spin-off studies, including prognostication of functional outcome after stroke, establishing the efficacy of revascularization intervention for patients with severe steno-occlusive disease who are at higher risk for recurrent stroke, as well as better characterization of neuropsychological profiles of VCI according to stroke etiological subtypes.

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