Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination

DIFFERENCE OF COGNITIVE IMPAIRMENT IN ISCHEMIC STROKE PATIENTS BASED ON HEMIPARESIS SIDEABSTRACTIntroduction: Cognitive impairment in stroke has a significant impact on the quality of life and is different from the location of the lesion. Patients with a lesion in the left cerebral hemisphere tend to have cognitive impairment and dementia.Aim: This study investigates the relationship between the location of the lesion, which is manifested by hemiparesis side, and the occurrence of cognitive impairment in ischemic stroke patients.Method: A cross-sectional study was conducted in the population of ischemic stroke patients at Atma Jaya Hospital, who were registered from January 2014 to December 2018. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Data were analyzed univariate and bivariate with the software program, statistical package for the social sciences (SPSS) version 25.0.Result: There were 125 patients included in this study, which predominantly was 55 years old and older (62.4%) and had a low education level (58.4%). The proportion of patients with right-sided hemiparesis (54.4%) was slightly higher than the left-side one (45.6%). No significant relationship was observed between the hemiparesis side and every cognitive function domain measured by MMSE and MoCA-Ina (p-value >0.05).Discussion Hemiparesis side indicating hemisphere lateralization in ischemic stroke patients showed no significant relationship with the occurrence of cognitive impairment based on MMSE and MoCA-Ina score. Keywords: Cognitive impairment, hemisphere lateralization, ischemic stroke, MMSE score, MoCA-Ina scoreABSTRAKPendahuluan: Gangguan kognitif pada stroke menyebabkan penurunan kualitas hidup dan berbeda berdasarkan letak lesi. Berdasarkan letak lesi, lesi di hemisfer serebri kiri lebih sering menyebabkan gangguan kognitif dan demensia.Tujuan: Tujuan penelitian untuk mengetahui pengaruh perbedaan letak lesi dilihat dari sisi hemiparesis terhadap gangguan kognitif pada subjek stroke iskemik.Metode: Studi potong lintang dilakukan pada pasien stroke iskemik di RS Atma Jaya periode tahun 2014- 2018. Fungsi kognitif dinilai dengan menggunakan Mini Mental State Examination(MMSE) danMontreal Cognitive Assesment Indonesian Version(MoCA-Ina). Analisis data dilakukan secara univariat dan bivariat menggunakan menggunakan program sStatistical pPackage for the sSocial sSciences (SPSS) versi 25.0.Hasil: Sebanyak 125 pasien tergabung dalam penelitian ini, yang sebagian besar berusia ≥55 tahun (62,4%) dan memiliki tingkat pendidikan <9 tahun (58,4%). Proporsi pasien dengan hemiparesis kanan (54,4%) lebih besar daripada kiri (45,6%). Tidak terdapat hubungan antara sisi hemiparesis dengan skor MMSE dan MoCA-Ina pada semua ranah (nilai p >0,05).Diskusi: Sisi hemiparesis pasien stroke iskemik yang menunjukkan lateralisasi hemisfer serebri tidak berhubungan dengan gangguan kognitif berdasarkan skor MMSE dan MoCA-Ina.Kata kunci: Gangguan kognitif, lateralisasi hemisfer, skor MMSE, skor MoCA-Ina, stroke iskemik

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GAMBARAN FUNGSI KOGNITIF PADA PASIEN STROKE NON HEMORAGIK MENGGUNAKAN MINI-MENTAL STATE EXAMINATION (MMSE) DI INSTALASI REHABILITASI MEDIK BLU RSUP PROF. DR. R. D KANDOU MANADO

e-CliniC ◽

10.35790/ecl.2.2.2014.4693 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Marchta Sinaga ◽

Lidwina Sengkey ◽

Engeliene Angliadi

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Mental State ◽

Cognitive Functions ◽

Mini Mental State Examination ◽

Haemorrhagic Stroke ◽

Medical Rehabilitation ◽

Stroke Patients ◽

Cross Sectional ◽

State Examination

Abstract: stroke is a great health concern because it causes pain, disability, mortality and is expensive in cost. Impaired cognitive function is the inability of decision making, impaired memory, disorientation, perceptual disturbances and thinking difficulties. Objective : to examine cognitive functions of non haemorrhagic stroke patients using the Mini-Mental State Examination in the Medical Rehabilitation Department of RSUP Prof. Dr. R. D Kandou Manado. Methods : This study use a cross section descriptive approach (cross sectional). Subjects were non haemorrhagic stroke patients who come to the medical rehabilitation department of Prof.Dr.R.D Kandou from November to December 2013. Results: 20 people (40%) were found with normal cognitive function, 28 people (56%) had mild cognitive impairment, while the remaining 2 people (4%) had severe cognitive impairment. Conclusion: it is found that there are impaired cognitive functions ranging from mild to severe in non haemorrhagic stroke patients, in which could affect the patients survival. Keywords: Stroke, Cognitive Function Abstrak: Stroke merupakan masalah penting bagi kesehatan karena menimbulkan kesakitan, kecacatan, kematian dan memerlukan biaya yang tinggi. Gangguan fungsi kognitif menunjukkan ketidakmampuan mengambil keputusan, gangguan memori , disorientasi, gangguan persepsi dan kesulitan berpikir. Tujuan: Mengetahui gambaran fungsi kognitif pada pasien stroke non hemoragik menggunakan Mini-Mental State Examination (MMSE) di Instalasi Rehabilitasi Medik BLU RSUP Prof. Dr. R. D Kandou Manado. Metode: Penelitian ini bersifat deskriptif dengan pendekatan potongan lintang (cross sectional). Subjek penelitian adalah penderita stroke non hemoragik yang datang ke Instalasi Rehabilitasi Medik BLU RSUP Prof. Dr. R.D Kandou Manado dari November-Desember 2013. Hasil: Ditemukan fungsi kognitif normal 20 orang (40%), gangguan fungsi kognitif ringan 28 orang (56%) dan yang mengalami gangguan fungsi kognitif berat 2 orang (4%). Simpulan: Ditemukan adanya gangguan fungsi kognitif ringan-berat pada pasien stroke non hemoragik yang berpengaruh pada kelangsungan hidup penderita. Kata Kunci: Stroke, Fungsi Kognitif

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Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010783.pub3 ◽

2021 ◽

Vol 2021 (7) ◽

Author(s):

Ingrid Arevalo-Rodriguez ◽

Nadja Smailagic ◽

Marta Roqué-Figuls ◽

Agustín Ciapponi ◽

Erick Sanchez-Perez ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Detection ◽

Mental State ◽

Mini Mental State Examination ◽

State Examination

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Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

Journal of Clinical Medicine ◽

10.3390/jcm10071385 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1385

Author(s):

Hyung Cheol Kim ◽

Seong Bae An ◽

Hyeongseok Jeon ◽

Tae Woo Kim ◽

Jae Keun Oh ◽

...

Keyword(s):

Cognitive Impairment ◽

Elderly Patients ◽

Mental State ◽

Mini Mental State Examination ◽

Operation Time ◽

Cognitive Status ◽

Blood Analysis ◽

Spinal Disease ◽

Degenerative Spinal Disease ◽

State Examination

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

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Can the MMSE help clinicians predict progression from mild cognitive impairment to dementia?

BJPsych Advances ◽

10.1192/apt.21.6.363 ◽

2015 ◽

Vol 21 (6) ◽

pp. 363-366 ◽

Cited By ~ 3

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Risk Prediction ◽

Mental State ◽

Mini Mental State Examination ◽

Case Finding ◽

Cognitive Test ◽

Prediction Tool ◽

State Examination

SummaryThe Mini-Mental State Examination (MMSE) is the most widely used bedside cognitive test. It has previously been shown to be poor as a case-finding tool for both dementia and mild cognitive impairment (MCI). This month's Cochrane Corner review examines whether the MMSE might be used as a risk prediction tool for later dementia in those with established MCI. From 11 studies of modest quality, it appears that the MMSE alone should not be relied on to predict later deterioration in people with MCI. As this is the case, it is likely that only a combination of predictors would be able to accurately predict progression from MCI to dementia.

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Random Forest Model in the Diagnosis of Dementia Patients with Normal Mini-Mental State Examination Scores

Journal of Personalized Medicine ◽

10.3390/jpm12010037 ◽

2022 ◽

Vol 12 (1) ◽

pp. 37

Author(s):

Jie Wang ◽

Zhuo Wang ◽

Ning Liu ◽

Caiyan Liu ◽

Chenhui Mao ◽

...

Keyword(s):

Machine Learning ◽

Cognitive Impairment ◽

Random Forest ◽

Mental State ◽

Mini Mental State Examination ◽

Machine Learning Algorithms ◽

Assessment Model ◽

Test Time ◽

Cognitive Screening ◽

State Examination

Background: Mini-Mental State Examination (MMSE) is the most widely used tool in cognitive screening. Some individuals with normal MMSE scores have extensive cognitive impairment. Systematic neuropsychological assessment should be performed in these patients. This study aimed to optimize the systematic neuropsychological test battery (NTB) by machine learning and develop new classification models for distinguishing mild cognitive impairment (MCI) and dementia among individuals with MMSE ≥ 26. Methods: 375 participants with MMSE ≥ 26 were assigned a diagnosis of cognitively unimpaired (CU) (n = 67), MCI (n = 174), or dementia (n = 134). We compared the performance of five machine learning algorithms, including logistic regression, decision tree, SVM, XGBoost, and random forest (RF), in identifying MCI and dementia. Results: RF performed best in identifying MCI and dementia. Six neuropsychological subtests with high-importance features were selected to form a simplified NTB, and the test time was cut in half. The AUC of the RF model was 0.89 for distinguishing MCI from CU, and 0.84 for distinguishing dementia from nondementia. Conclusions: This simplified cognitive assessment model can be useful for the diagnosis of MCI and dementia in patients with normal MMSE. It not only optimizes the content of cognitive evaluation, but also improves diagnosis and reduces missed diagnosis.

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A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2008.04.014 ◽

2009 ◽

Vol 43 (4) ◽

pp. 411-431 ◽

Cited By ~ 457

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mental State ◽

Mini Mental State Examination ◽

Meta Analysis ◽

State Examination

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Detection of mild cognitive impairment in middle-aged and older adults with obstructive sleep apnoea

European Respiratory Journal ◽

10.1183/13993003.01137-2018 ◽

2018 ◽

Vol 52 (5) ◽

pp. 1801137 ◽

Cited By ~ 7

Author(s):

Katia Gagnon ◽

Andrée-Ann Baril ◽

Jacques Montplaisir ◽

Julie Carrier ◽

Sirin Chami ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Obstructive Sleep Apnoea ◽

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Sleep Apnoea ◽

Screening Tests ◽

Obstructive Sleep ◽

State Examination

Obstructive sleep apnoea increases the risk for mild cognitive impairment and dementia. The present study aimed to characterise the ability of two cognitive screening tests, the Mini-Mental State Examination and the Montreal Cognitive Assessment, to detect mild cognitive impairment in adults aged 55–85 years with and without obstructive sleep apnoea.We included 42 subjects with mild and 67 subjects with moderate-to-severe obstructive sleep apnoea. We compared them to 22 control subjects. Mild cognitive impairment was diagnosed by a comprehensive neuropsychological assessment. We used receiver operating characteristic curves to assess the ability of the two screening tests to detect mild cognitive impairment.The two screening tests showed similar discriminative ability in control subjects. However, among the mild and the moderate-to-severe obstructive sleep apnoea groups, the Mini-Mental State Examination was not able to correctly identify subjects with mild cognitive impairment. The Montreal Cognitive Assessment's discriminant ability was acceptable in both sleep apnoea groups and was comparable to what was observed in controls.The Mini-Mental State Examination should not be used to screen for cognitive impairment in patients with obstructive sleep apnoea. The Montreal Cognitive Assessment could be used in clinical settings. However, clinicians should refer patients for neuropsychological assessment when neurodegenerative processes are suspected.

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