You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Cognitive Performance in Asymptomatic Patients With Advanced Carotid Disease

Martinic Popovic, Irena MD, PhD*; Lovrencic-Huzjan, Arijana MD, PhD*; Simundic, Ana-Maria PhD; Popovic, Alek MD, PhD; Seric, Vesna MD, PhD*; Demarin, Vida MD, PhD*

Cognitive & Behavioral Neurology:
doi: 10.1097/WNN.0b013e3182313020
Original Studies
Abstract

Objective: In the absence of stroke or transient ischemic attack, patients with advanced carotid stenosis or occlusion (ICAs/o) are considered asymptomatic, yet they are prone to mostly subtle cognitive impairment.

Background: The Mini-Mental State Examination (MMSE) often fails to detect mild cognitive impairment. The Montreal Cognitive Assessment (MoCA) is more sensitive in recognizing such changes.

Methods: Scores on the MoCA and MMSE were compared in 70 asymptomatic patients with ICAs/o and 70 controls matched for demographic variables and vascular risk factors.

Results: MMSE scores fell mostly within the normal range in both patients and controls. Differences were significant for total MoCA scores (P<0.001). Patients with ICAs/o performed worse on visuospatial and executive function (P=0.018), abstraction (P<0.001), and delayed recall (P<0.001). Lower MoCA scores were associated with diabetes (odds ratio=6.41; 95% confidence interval, 1.277-32.220; P=0.024) and older age (odds ratio=0.86; 95% confidence interval, 0.780-0.956; P=0.004). Patients with diabetes performed worse on delayed recall (P<0.001), and patients with hypertension were worse on the MoCA naming subtest (P=0.04).

Conclusions: The MoCA successfully identified reduced cognitive status in patients with ICAs/o. The MoCA subtest scores revealed a pattern of cognitive impairment similar to that documented in other studies using more extensive neuropsychological tests. MoCA could be used as part of the clinical evaluation of patients with ICAs/o.

Author Information

*University Department of Neurology

Clinical Institute of Chemistry

University Department of Urology, “Sestre milosrdnice” University Hospital Centre, Zagreb, Croatia

The authors declare no conflicts of interest.

Reprints: Irena Martinic Popovic, MD, PhD, University Department of Neurology, “Sestre milosrdnice” University Hospital Centre, Vinogradska c. 29, Zagreb 10000, Croatia (e-mail: irene@mail.inet.hr).

Received March 15, 2011

Accepted August 3, 2011

© 2011 Lippincott Williams & Wilkins, Inc.