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Keywords:

  • cerebral aneurysm;
  • cognition;
  • Mini-Mental State Examination;
  • Montreal Cognitive Assessment;
  • subarachnoid hemorrhage

Background and purpose

After aneurysmal subarachnoid hemorrhage (aSAH), cognitive impairment, even mild and relatively isolated, can be devastating, especially in working-age persons. The Montreal Cognitive Assessment (MoCA) is accepted as a valid screening tool for mild cognitive impairment due to cerebral ischaemia. Whether MoCA is independently associated with excellent outcome [a score of 0 on the modified Rankin Scale (mRS) or 18/18 on the Lawton Instrumental Activities of Daily Living (IADL) scale] 1 year after aSAH was assessed.

Methods

Hong Kong Chinese aSAH patients were assessed prospectively by means of the MoCA, Mini-Mental State Examination (MMSE), mRS and IADL scale at 1 year. This multicenter prospective observational study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).

Results

In all, 194 patients completed the assessments at 1 year. After adjustment for age, both excellent IADL and mRS outcomes were associated with MoCA (OR 1.2, 95% CI 1.1–1.3, < 0.001, and OR 1.1, 95% CI 1.0–1.2, = 0.001, respectively).

Conclusions

MoCA-assessed cognitive function is an important determinant for excellent outcomes after aSAH.