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The Mouse Stroke Unit Protocol with Standardized Neurological Scoring for Translational Mouse Stroke Studies
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How predictive is the MMSE for cognitive performance after stroke?

Ariane Bour1, Sascha Rasquin, Anita Boreas

  • 1Department of Neurology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. a.bour@mumc.nl

Journal of Neurology
|April 3, 2010
PubMed
Summary

The Mini-Mental State Examination (MMSE) adequately screens for moderate cognitive deficits and dementia in stroke patients one month post-stroke. However, it cannot predict long-term cognitive changes or recovery.

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Area of Science:

  • Neurology
  • Neuropsychology
  • Geriatrics

Background:

  • Cognitive deficits are common after stroke, impacting patient recovery.
  • Current neuropsychological testing is lengthy and difficult for post-discharge assessment.
  • Standardized screening tools are needed for cognitive evaluation in stroke survivors.

Purpose of the Study:

  • To evaluate the Mini-Mental State Examination's (MMSE) ability to screen for cognitive impairment and dementia post-stroke.
  • To determine if MMSE scores can predict cognitive deterioration or improvement over time.
  • To establish MMSE cut-off scores for different levels of cognitive impairment.

Main Methods:

  • A longitudinal study of 194 first-ever stroke patients without prior cognitive issues.
  • Patients completed MMSE and comprehensive neuropsychological tests at 1, 6, 12, and 24 months post-stroke.
  • Analysis focused on MMSE predictive accuracy for cognitive status and changes.

Main Results:

  • MMSE scores at 1 month post-stroke predicted later cognitive functioning.
  • The MMSE demonstrated modest sensitivity for mild cognitive disturbances (cut-off 27/28, sensitivity 0.72).
  • Adequate screening for moderate deficits (cut-off 26/27, sensitivity 0.82) and dementia (cut-off 23/24, sensitivity 0.96) was observed.
  • The MMSE could not predict cognitive deterioration or improvement over time.

Conclusions:

  • The MMSE is a useful screening tool for moderate to severe cognitive impairment and dementia in stroke patients one month after the event.
  • Poor MMSE performance predicts long-term cognitive impairment but not future cognitive trajectory.
  • Further research may be needed to identify tools that can predict cognitive changes post-stroke.