The paper aims to determine the effect of acute ischemic stroke on cognition using the MMSE and other neuropsychological tests.

All patients admitted at the University of Santo Tomas Hospital Pay Division for acute ischemic stroke from July to August 2007 were included in the study. Eligible patients underwent Mini-Mental State Examination (MMSE) and a detailed neuropsychological testing to characterize cognitive functioning in 6 domains: attention, executive functioning, language, visuospatial ability, visuomotor speed and memory. Scores were presented as mean standard deviation and frequency of cognitive impairment was determined. Chi square and logistic regression was used to examine the association between stroke and the impaired cognitive domain.

There were twenty-five participants eligible in the study. The mean age of the participants was 58.0 ± 13.3, the mean educational level (in years) was 11.6 ± 3.4, the mean MMSE score was 26.4 ± 3.0 and the mean NIHSS score was 4.2 ± 1.8. With a cutoff score of 23 and below, 4 (16%) patients failed the MMSE. On neuropsychological testing, however, all patients failed in at least one area of cognitive domain being tested. Among these patients, 60% failed in the test for visuospatial and executive functions while 92% failed in the test for visuomotor speed.

The prevalence of cognitive impairment after an acute ischemic stroke is 16% using the MMSE. Neuropsychological assessment revealed cognitive impairment in all these patients. The results suggest that the role of MMSE in detecting post stroke cognitive impairment in the acute setting maybe limited. More specific neuropsychological tests should be incorporated to detect subtle cognitive impairment especially instruments that test the areas of visuospatial, visuomotor speed and executive functions.