POS05 Impairment on Montreal Cognitive Assessment in transient ischaemic attack and stroke patients with normal Mini-Mental State Examination score is clinically relevant
Bibliographic record
Abstract
Background We have shown that over 50% of transient ischaemic attack (TIA) and stroke patients with MMSE≥27, score below the cut-off for normal cognitive function on the Montreal Cognitive Assessment (MoCA). However, it is uncertain whether these patients have clinically relevant cognitive problems. We therefore aimed to determine the clinical, functional and neuropsychological characteristics of this group. Methods Consecutive patients with transient ischaemic attack (TIA) or stroke had the MMSE, MoCA, Rankin score, Addenbrooke9s cognitive examination-revised (ACE-R) and neuropsychological battery (trail test, Hopkins verbal learning test (HVLT), digit symbol substitution test (DSST), Boston naming test) at least 6 months after the index event. Patients with MMSE≥27 were grouped as MoCA-normal (MoCA≥26), or MoCA-impaired (MoCA<26). Results The MoCA-impaired group (n=162) were more likely than the MoCA-normal group (n=122) to have had a stroke rather than a transient ischaemic attack (TIA) (97/162 vs 50/122, OR 2.15, p=0.0016) and had higher Rankin scores (p<0.0001). All neuropsychological battery test scores and total ACE-R score were significantly (p<0.01) worse in the MoCA-impaired group than in the MoCA-normal group. Differences were greatest for the DSST (executive function/attention) and the HVLT (memory). Conclusion In patients with normal MMSE, impairment on the MoCA is associated with stroke vs TIA, with greater dependency, and with worse performance on neuropsychological battery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".