Analysis of cognitive dysfunction with silent cerebral infarction: a prospective study in Chinese patients

To investigate the relationship between Silent Cerebral Infarction (SCI) and cognitive impairment to testify that Montreal Cognitive Assessment (MoCA) is a more sensitive screening tool than the Mini Mental State Examination (MMSE) to identify cognitive deficits in patients with SCI. We recruited 196 individuals in Shanghai of China and divided them into 2 groups: the SCI group including 112 individuals (45 men and 67 women; aged from 43 to 70 years old) and the control group including 84 individuals (43 men and 41 women; aged from 42 to 79 years old). We collected information including participants' gender, age, blood glucose, kidney function, blood lipids, blood pressure, Electrocardiogram (ECG), carotid artery ultrasound, MMSE score, and MoCA score. SAS software (version 9.1) was used to perform statistical analysis on physical examinations outcomes from 196 participants. Furthermore, multiple logistic regression model was built up to screen out the independent risk factors of SCI. Besides, Receiver Operator Characteristic (ROC) analysis was also used. Multivariate logistic regression analysis showed that abnormal ECG and existence of carotid artery plaques were independent risk factors of SCI occurrence, while MoCA scores was negatively associated with SCI risk. Moreover, MoCA might be more valuable in predicting vascular cognitive impairment (VCI) than MMSE (0.667 vs 0.626). We found that the MMSE was generally insensitive to detect cognitive impairment; but the MoCA has a good balance of sensitivity and specificity at the cut-score of 26. We found that the patients with SCI might accompany with VCI and the MoCA appeared to be an excellent screening test for patients with SCI, worthy of being promoted in the clinical practitioning on Chinese population.