Cognitive performance in asymptomatic patients with advanced carotid disease

• Published in: Cognitive and behavioral neurology Vol. 24; no. 3; p. 145
• Main Authors: Popovic, Irena Martinic, Lovrencic-Huzjan, Arijana, Simundic, Ana-Maria, Popovic, Alek, Seric, Vesna, Demarin, Vida
• Format: Journal Article
• Language: English
• Published: United States 01.09.2011
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Carotid Artery Thrombosis - complications; Carotid Artery Thrombosis - psychology; Carotid Artery, Internal - pathology; Carotid Stenosis - complications; Carotid Stenosis - diagnosis; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - psychology; Cognitive Dysfunction - complications; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - psychology; Diabetes Mellitus - psychology; Echocardiography, Doppler, Color - methods; Echocardiography, Doppler, Color - psychology; Executive Function; Female; Humans; Hypertension - psychology; Male; Mental Status Schedule - statistics & numerical data; Middle Aged; Neuropsychological Tests - statistics & numerical data; Tomography, X-Ray Computed - methods; Tomography, X-Ray Computed - psychology
• ISSN: 1543-3641
• DOI: 10.1097/WNN.0b013e3182313020

: 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. : 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. : 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. : 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). : 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.