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Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study
Pendlebury ST, Cuthbertson FC, Welch SJ, Mehta Z, Rothwell PM.. Stroke, 2010-04-08
Topic: Risk, prevention and care in population studies
Background and purpose The Mini-Mental State Examination (MMSE) is insensitive to mild cognitive impairment and executive function. The more recently developed Montreal Cognitive Assessment (MoCA), an alternative, brief 30-point global cognitive screen, might pick up more cognitive abnormalities in patients with cerebrovascular disease. Methods In a population-based study (Oxford Vascular Study) of transient ischemic attack and stroke, the MMSE and MoCA were administered to consecutive patients at 6-month or 5-year follow-up. Accepted cutoffs of MMSE Results Of 493 patients, 413 (84%) were testable. Untestable patients were older (75.5 versus 69.9 years, P or =27, whereas only 5 patients had MoCA > or =26 and MMSE or =27, MoCA Conclusions The MoCA picked up substantially more cognitive abnormalities after transient ischemic attack and stroke than the MMSE, demonstrating deficits in executive function, attention, and delayed recall.
Key findings
- Accepted cutoffs of MMSE Results Of 493 patients, 413 (84%) were testable.
- Untestable patients were older (75.5 versus 69.9 years, P or =27, whereas only 5 patients had MoCA > or =26 and MMSE or =27, MoCA Conclusions The MoCA picked up substantially more cognitive abnormalities after transient ischemic attack and stroke than the MMSE, demonstrating deficits in executive fu
Why it matters
In patients who had a transient ischemic attack or stroke, the Montreal Cognitive Assessment detected substantially more cognitive abnormalities than the Mini-Mental State Examination, including deficits in executive function, attention, and delayed recall. This suggests the choice of cognitive screening tool affects how often cognitive problems are found in this group.
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Study details
- Participants493
- Evidence strengthLow
How this study scored 58/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 493 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 482 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.8 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 5 / 6 | Cited 21.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 22 other studies in this library |
| Still being cited | 3 / 4 | Cited 69 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Peter Malcolm Rothwell: h-index 152 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20378863) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 58 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Pendlebury, S. T., Cuthbertson, F. C., Welch, S. J., Mehta, Z., & Rothwell, P. M. (2010). Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study. Stroke. https://doi.org/10.1161/strokeaha.110.579888
Vancouver
Pendlebury ST, Cuthbertson FC, Welch SJ, Mehta Z, Rothwell PM. Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study. Stroke. 2010. doi:10.1161/strokeaha.110.579888. PMID: 20378863.
BibTeX
@article{pendlebury2010-20378863,
author = {Pendlebury, S. T. and Cuthbertson, F. C. and Welch, S. J. and Mehta, Z. and Rothwell, P. M.},
title = {{Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study}},
journal = {Stroke},
year = {2010},
doi = {10.1161/strokeaha.110.579888},
pmid = {20378863},
url = {https://doi.org/10.1161/strokeaha.110.579888}
}
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