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Master Thesis

Comparaison du Mini Mental State Examination (MMSE) et du Montréal Cognitive Assessment (MoCA) pour le dépistage des troubles cognitifs chez les patients âgés à haut risque cardiovasculaire : étude randomisée contrôlée en soins primaires

Abstract : Introduction : Cognitive impairment is associated with compliance issues and worse outcomes in patients with chronic diseases. The French Society of Hypertension recommends using the MMSE to screen for cognitive impairment in older hypertensive patients. The aim of this study was to compare the yield of the MMSE and of the MoCA, a screening test known to be more sensitive for vascular dementia and mild cognitive impairment (TCL), in older outpatients at high cardiovascular risk.
Methods : Independently living patients over 65 who were prescribed a treatment for cardiovascular prevention and followed-up by their general practitioner were recruited in a health center. Each patient was randomly assigned to undergo either the MMSE or the MoCA. A MMSE score <27 (or 24 if high school was not completed) or MoCA score <26 (or 25) was considered as indicating cognitive impairment.
Results : Patients randomized to the MMSE (n=55) were similar to those randomized to the MoCA (n=56). Cognitive assessment duration was a little more than 10 min with both tests. There were 22 (40%) screen positive with the MMSE and 38 (68%) with the MoCA (p<0,004 for the difference).
Conclusion : Cognitive impairment is very frequent in patients over 65 years treated for cardiovascular prevention in primary care, and largely unrecognized by physicians despite its wide ranging consequences including therapeutic non-compliance. Screening guidelines should promote use of the MoCA rather than the MMSE in these patients, since it is able to better detect vascular dementia and mild cognitive impairment with a similar screening time.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01179100
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Submitted on : Tuesday, July 21, 2015 - 4:09:06 PM
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  • HAL Id : dumas-01179100, version 1

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Charlotte Golstein. Comparaison du Mini Mental State Examination (MMSE) et du Montréal Cognitive Assessment (MoCA) pour le dépistage des troubles cognitifs chez les patients âgés à haut risque cardiovasculaire : étude randomisée contrôlée en soins primaires. Médecine humaine et pathologie. 2014. ⟨dumas-01179100⟩

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