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MoCA-assessed cognitive function and excellent outcome after aneurysmal subarachnoid hemorrhage at 1 year

Authors

  • G. K. C. Wong,

    Corresponding author
    1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
    • Correspondence: G. K. C. Wong, Department of Surgery, 4/F Clinical Science Building, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, China (tel.: (852) 2632 2624; fax: (852) 2637 7974; e-mail: georgewong@surgery.cuhk.edu.hk).

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  • S. W. Lam,

    1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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  • A. Wong,

    1. Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
    2. Department of Psychological Studies, Hong Kong Institute of Education, New Territories, Hong Kong SAR, China
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  • M. Lai,

    1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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  • D. Siu,

    1. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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  • W. S. Poon,

    1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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  • V. Mok

    1. Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Abstract

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.

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