论文部分内容阅读
Objective Montreal cognitive assessment (MoCA) was used for evaluating patients with vascular cognitive impairment no dementia (VCIND) after isehemia stroke.There is a possibility that the educational backgrounds may affect the score of MoCA.Methods Cognitive impairment of the patients who had no cognitive impairment (NCI) or VCIND was evaluated using MoCA.ROC curve and maximal Youden index were generated to determine the best cut-off point for identifying NCI and VCIND.Sensitivity and specificity of MoCA screening VCIND were calculated and evaluated, at educational levels of primary,secondary and college.Results Included patients consisted ofNCI (n=111) and VCIND (n=95).There was no significant difference between two groups in overall educational background.For primary education group,significant differences in each item of MoCA were found between NCI patients and VCIND patients, except naming.For patients in secondary educational group, significant differences in each item of MoCA were found between NCI and VCIND,except naming, attention and calculation.For the college group, significant differences were found in items of visuo/executive, abstraction, memory (P＜0.05).The optimal cut-off score of MoCA was 22/23 in identifying VCIND according to the ROC curve analyses and the maximal Youden index.With the cut-off point, MoCA showed a sensitivity of 65.26％ and a specificity of78.73％.Classifying patients into primary,secondary,college levels of education,sensitivity and specificity were (97.06％, 47.22％), (56.10％, 87.80％), (40％, 100％), respectively. Conclusion For screening in patients with VCIND caused by ischemic stroke, MoCA has high specificity.Different educational backgrounds have effects to change the ability of patients to complete MoCA item tests.It is suggested that the score of MoCA be amended based on educational levels in order to improve effectiveness in the screening.