Therefore, detection and monitoring of cognitive impairment is required in an increasing number of contexts to ensure adequate care of the patient with stroke or other vascular disorder. However, it is now well recognized that progressive declines in cognitive functioning may result from cerebrovascular disease even in the absence of a clinically detectable precipitating event. Traditionally, vascular cognitive impairment was understood uniquely as a condition resulting from a symptomatic ischaemic or haemorrhagic event, i.e. However, it compares favourably to the Mini Mental State Examination as a screening test that is sensitive to the milder forms of cognitive impairment that often accompany cerebrovascular disease.Ĭognitive impairment is a common consequence of stroke with a significant impact on response to rehabilitation, ability to return to work and ability to resume participation in society. Further research is needed to provide evidence for the validity of the MoCA in longitudinal studies. The MoCA correlates well with other measures of cognitive and functional abilities in patients with cerebrovascular disease, and may also predict future response to rehabilitation and long-term occupational outcome. Recent modifications of the MoCA have been developed for assessing patients with visual impairment or restricted mobility, which may reduce the impact of ‘untestability' on cognitive screening in the clinic or research context.

Evidence clearly supports the need to establish norms and cut-offs for the MoCA that are culturally appropriate and that are matched to the range of cognitive impairment that is present in the population being assessed. Nevertheless, content validity evidence suggests that the MoCA covers most of the domains that represent cognitive impairment in cerebrovascular disease, with mixed evidence for its preferential sensitivity to the type of cognitive impairment encountered in the context of vascular disease. Under-specification of the exclusion criteria applied and their impact make it difficult to assess the potential impact of sampling bias and loss to follow-up. Reporting of the methods and results of such studies tended to fall short of the established reporting guidelines. A total of 30 papers employing the MoCA in the context of cerebrovascular disease were identified. This paper presents a critical review of the research literature evaluating the validity and utility of this test with the aim of informing future clinical and research practice. The Montreal Cognitive Assessment (MoCA) has been suggested as a brief screening test of vascular cognitive impairment. Recognition and monitoring of mild cognitive impairment is thus essential to good patient care.

Cognitive impairment is common among patients with stroke or other cerebrovascular disease and influences long-term outcome, including occupational functioning.

What is the moca cognitive assessment