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Updated: May 31, 2026
Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
The montreal cognitive assessment: short cognitive evaluation in a large stroke trial
Toby B Cumming1, Julie Bernhardt, Thomas Linden
1National Stroke Research Institute, Florey Neuroscience Institutes, Melbourne, Australia. tcumming@unimelb.edu.au
Background And Purpose:
Cognitive function is often ignored in stroke research trials. The brief Montreal Cognitive Assessment (MoCA) may be sensitive to stroke-related cognitive deficits.
Methods:
We evaluated the feasibility of administering the MoCA at 3 months in a large stroke trial (A Very Early Rehabilitation Trial [AVERT]).
Results:
Data (blinded to intervention group) are presented for 294 patients with mean age of 70.6 years (SD, 12.8); 220 (75%) completed the MoCA, 54 (18%) had missing data, and 20 (7%) had died. Of those surviving to 3 months, the MoCA was completed by 87% with mild stroke, 79% with moderate stroke, and 67% with severe stroke on admission. Mean MoCA score was 21.1 (SD 7.5) out of 30; only 78 of 220 (35%) patients attained the "normal" cutoff (≥26).
Conclusions:
The MoCA is a feasible global cognitive screening tool in stroke trials. Clinical Trial Registration- URL: www.anzctr.org.au/trial_view.aspx?ID=1266. Unique identifier: ACTRN12606000185561.
Insights
The Montreal Cognitive Assessment (MoCA) is a feasible tool for screening cognitive deficits in stroke patients. Most participants in a large trial scored below the normal range, highlighting the need for cognitive assessment post-stroke.
Area of Science:
- Neurology
- Clinical Trials
- Cognitive Science
Background:
- Cognitive function is frequently overlooked in stroke research.
- The Montreal Cognitive Assessment (MoCA) shows promise for detecting stroke-related cognitive impairments.
Purpose of the Study:
- To assess the feasibility of using the MoCA at three months post-stroke within a large clinical trial.
- To evaluate the MoCA's utility as a global cognitive screening tool in stroke research.
Main Methods:
- The Montreal Cognitive Assessment (MoCA) was administered to patients in the A Very Early Rehabilitation Trial (AVERT).
- Feasibility was assessed based on completion rates, missing data, and mortality at three months.
Main Results:
- Out of 294 patients, 220 (75%) completed the MoCA; 35% scored within the normal range (≥26).
- Completion rates varied by stroke severity: 87% for mild, 79% for moderate, and 67% for severe stroke.
- The mean MoCA score was 21.1 (SD 7.5), indicating widespread cognitive deficits.
Conclusions:
- The Montreal Cognitive Assessment (MoCA) is a practical and feasible tool for cognitive screening in stroke clinical trials.
- Results suggest a high prevalence of cognitive deficits among stroke survivors, underscoring the importance of routine cognitive assessment.
