Related Experiment Video
Updated: Jun 2, 2026
Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients
Published on: March 11, 2021
The Mini-Mental State Examination and Montreal Cognitive Assessment in persons with mild subacute stroke:
Joan Toglia1, Kerri A Fitzgerald, Michael W O'Dell
1Mercy College, 555 Broadway, Dobbs Ferry, NY 10522, USA. jtoglia@mercy.edu
Objectives:
To compare Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) global and subscores in classifying cognitive impairment in persons with mild stroke and to explore the relationship between admission and discharge functional status and improvement.
Design:
Retrospective analysis of data.
Setting:
Acute rehabilitation unit of a large urban university-affiliated hospital.
Participants:
Inpatients with stroke (N=72; mean age, 70y; median time poststroke, 8.5d) and mild neurologic (median National Institutes of Health Stroke Scale score, 4) and cognitive deficits (median MMSE score, 25).
Intervention:
Not applicable.
Main Outcome Measure:
Admission cognitive status was assessed by using the MMSE and MoCA. The motor subscale of the FIM instrument (mFIM) and motor relative functional efficiency was used to assess discharge functional status and improvement.
Results:
The MoCA classified more persons as cognitively impaired than the MMSE (89% vs 63%, respectively; using a cutoff score of 27 on the MMSE and 26 on the MoCA). The MoCA also showed less of a ceiling effect than the MMSE, higher internal reliability (Cronbach α=.78 compared with α=.60), and marginally stronger associations with discharge functional status (r=.40; P<.001) than the MMSE (r=0.30; P<.05). The MoCA visuoexecutive subscore was the strongest predictor of functional status (P=.01) and improvement (P=.02) in global and subscores for both tests.
Conclusions:
The MoCA may be an important cognitive screening tool for persons with stroke and mild cognitive dysfunction on an acute rehabilitation unit. Lower visuoexecutive subscores may assist in identifying persons at risk for decreased functional gains in self-care and mobility (mFIM) during inpatient rehabilitation. The findings justify further validation studies of the MoCA in persons with subacute stroke.
Insights
The Montreal Cognitive Assessment (MoCA) is a better tool than the Mini-Mental State Examination (MMSE) for identifying cognitive impairment in stroke patients. MoCA
Area of Science:
- Neuroscience
- Gerontology
- Rehabilitation Medicine
Background:
- Cognitive impairment is common after stroke.
- Accurate cognitive screening is crucial for rehabilitation planning.
- The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) are commonly used screening tools.
Purpose of the Study:
- Compare the efficacy of MoCA and MMSE in classifying cognitive impairment in mild stroke patients.
- Examine the relationship between cognitive assessment scores and functional outcomes post-stroke.
- Investigate the predictive value of MoCA subscores for functional improvement.
Main Methods:
- Retrospective analysis of inpatient data from an acute rehabilitation unit.
- Participants (N=72) had mild stroke and cognitive deficits.
- Cognitive status assessed using MoCA and MMSE; functional status using the motor subscale of the FIM instrument (mFIM).
Main Results:
- MoCA identified more patients with cognitive impairment (89%) than MMSE (63%).
- MoCA demonstrated a lower ceiling effect, higher reliability, and stronger association with discharge functional status.
- The MoCA visuoexecutive subscore was the strongest predictor of functional status and improvement.
Conclusions:
- MoCA is a valuable screening tool for stroke patients with mild cognitive dysfunction.
- Lower MoCA visuoexecutive scores may predict reduced functional gains in self-care and mobility.
- Further validation of MoCA in subacute stroke populations is warranted.
