Abstract
Determine whether the Montreal Cognitive Assessment (MoCA), a paper-and-pencil screen, or the Menu Task (MT), a functional cognitive screen, is better at predicting function, readmissions, and falls 30 days after discharge in stroke patients with mild cognitive impairment.
Primary Author and Speaker: Lisa A. Lowenthal
Additional Authors and Speakers: Daniel Geller
The purpose of this study was to determine 1) the correlation between the Montreal Cognitive Assessment (MoCA), a gold standard cognitive screen, and the Menu Task (MT), a functional cognitive assessment in acute stroke, and 2) whether the MoCA or MT is superior at predicting function, readmission, and falls 30-days after discharge in mildly cognitively impaired acute stroke patients. A prospective predictive correlational study to compare the MoCA to the MT. Participants over the age of 18 were recruited from an acute care hospital in a suburban hospital. All participants had sustained an acute stroke and scored an 18–25 on the MoCA indicative of a mild cognitive impairment. The MoCA and the MT were completed by the 3rd occupational therapy visit. Data were collected, by phone call, at 1-month follow up to assess function via the Lawton Instrumental Activity of Daily Living scale and Modified Rankin Scale-9Q and falls through an open ended question. Readmissions were determined by the electronic medical record. Correlational statistics were used to determine the correlation between the MoCA and MT. Regression analysis was used for predictive purposes for falls, readmission, and function 1-month post discharge. Eighty participants (30% female, mean age = 63.2) were included in the analysis. Spearman’s correlation yielded a low positive correlation between the MoCA and the MT (r = .05). The MT outperformed the MoCA when predicting function and readmissions, however results were not statistically significant. The MoCA and the MT both were not predictors of falls. The MT shows promise as a feasible tool to use in the acute care setting for mildly cognitively impaired acute stroke patients, thus showing the importance of moving towards performance-based testing. A larger sample size would be beneficial to further investigate the correlation between the MoCA and the MT as well as predictive capabilities on function, falls, and readmissions.
Al-Heizan, M.O, Giles, G.M., Wolf, T.J., & Edwards, D.F. (2020). The construct validity of a new screening measure of functional cognitive ability: The menu task. Neuropsychological Rehabilitation, 30(5), 961–972. https://doi.org/10.1080/09602011.2018.1531767
Edwards, D. F., Wolf, T. J., Marks, T., Alter, S., Larkin, V., Padesky, B. L., Spiers, M., Al-Heizan, M. O., & Giles, G. M. (2019). Reliability and validity of a functional cognition screening tool to identify the need for occupational therapy. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 73(2), 7302205050p1–7302205050p10. https://doi.org/10.5014/ajot.2019.028753
El Husseini, N., Katzan, I., Rost, N. S., Blake, M. L., Byun, E., Pendlebury, S. T., Aparicio, H. J., Marquine, M. J., Gottesman, R. F., & Smith, E. E. (2023). Cognitive impairment after ischemic and hemorrhagic stroke: A scientific statement from the American Heart Association/American Stroke Association. Stroke (1970), 54(6). https://doi.org/10.1161/str.0000000000000430