Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 May 18;272(6):407.
doi: 10.1007/s00415-025-13146-5.

MoCA and MMSE for the detection of post-stroke cognitive impairment: a comparative diagnostic test accuracy systematic review and meta‑analysis

Xiaoqin Wei #  1   2 , Yuxiang Liu #  3 , Jia Li  2   4 , Ying Zhu  2 , Wenyuan Li  2 , Yu Zhu  2 , Longchun Hua  5 , Jianxun Cao  6 , Yuxia Ma  7
Affiliations
Meta-Analysis

MoCA and MMSE for the detection of post-stroke cognitive impairment: a comparative diagnostic test accuracy systematic review and meta‑analysis

Xiaoqin Wei et al. J Neurol. .

Abstract

Background and purpose: Post-stroke cognitive impairment (PSCI) is one of the serious complications of stroke, which profoundly influences the quality of life of stroke survivors. The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) are the two cognitive screening tools most widely used in stroke settings. Previous studies investigated the diagnostic accuracy of MoCA and MMSE but yielded controversial results. We conducted this study to compare the diagnostic accuracy of MoCA with MMSE for PSCI.

Methods: Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were searched until August 17, 2024 for diagnostic accuracy studies comparing MoCA and MMSE. Data extraction was performed by two independent researchers. Risk of bias and applicability assessment was evaluated by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Coupled forest plots and hierarchical summary receiver operating characteristic (hsROC) curves were created in R statistical software.

Results: 9 studies with 1,135 patients were included in this review. Most studies were at high risk of bias. MoCA displayed a pooled sensitivity of 0.80 (95% CI 0.72 to 0.86) and specificity of 0.79 (95% CI 0.71 to 0.85). MMSE displayed a sensitivity and specificity of 0.76 (95% CI 0.71 to 0.81) and 0.78 (95% CI 0.73 to 0.83), respectively. No difference was shown between these modalities (SEN p = 0.36, SPE p = 0.80).

Conclusion: No difference was observed between MoCA and MMSE in the detection of PSCI. We recommend both screeners be considered for the detection of PSCI based on the purpose of the test and by other metrics, such as acceptability and feasibility. Although it should be noted MoCA and MMSE were cognitive screening tools in stroke settings and not a substitute for detailed clinical assessment.

Keywords: Diagnostic accuracy; Meta‑analysis; Mini-mental state examination; Montreal cognitive assessment; Post-stroke cognitive impairment.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no conflicts of interest. Ethical approval: Not applicable.

Similar articles

See all similar articles

Cited by

References

    1. Collaborators GS (2021) Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the global burden of disease study 2019. The Lancet Neurol 20:795–820 - DOI
    1. Gerstl JVE, Blitz SE, Qu QR et al (2023) Global, regional, and national economic consequences of stroke. Stroke 54:2380–2389 - DOI - PubMed - PMC
    1. Jaracz K, Grabowska-Fudala B, Jaracz J et al (2024) Caregiver burden after stroke: a 10-year follow-up study of Polish caregivers for stroke patients. BMC Nurs 23:589 - DOI - PubMed - PMC
    1. Cramer SC, Richards LG, Bernhardt J et al (2023) Cognitive deficits after stroke. Stroke 54:5–9 - DOI - PubMed
    1. Labeit B, Michou E, Hamdy S et al (2023) The assessment of dysphagia after stroke: state of the art and future directions. The Lancet Neurol 22:858–870 - DOI - PubMed

MeSH terms

LinkOut - more resources