IOSR Journal of Nursing and Health Science (IOSR-JNHS) e- ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 7, Issue 3 Ver. V (May-June .2018), PP 85-92 www.iosrjournals.org DOI: 10.9790/1959-0703058592 www.iosrjournals.org 85 | Page A Comparison of Different Cognitive Screening Instruments on Early Detection of Mild Cognitive Impairments in Post-Stroke Patients. Ayman A. Nassif 1 , Moataz M. El Semary 1 , Ghada A. Abdallah 2 , Rabab A. Mohamed 2 , 1 (Physical Therapy for Neuromuscular disorders and its surgery Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.) 2 (Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt). Corresponding Author:Ayman A. Nassif Abstract: Strokes pathology creating negative effects on brain structure producing both physical and cognitive impairments, the recovery of both are time sensitive. Early detection of cognitive impairment (CI) is crucial to augment recovery rate. Formal cognitive assessment often needs 2-4 hours, which may not be clinically available. There is a need of an efficient cognitive screening test as an aide for subsequent proper referral to neuropsychologists for a thorough neuropsychological assessment. The Mini mental state Examination (MMSE), The Montreal Cognitive assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) are commonly used as screening tools for CI. Thisstudy aimed to compare the proportions of MCI determined by different cognitive screening instruments (CSI), identifying the most effective one. This was a cross-sectional study for stroke patients with age 55.81±3.03 years, and stroke duration 4.86±0.73 months. The proportion of MCI identified using MMSE, MoCA and ACE-R were 40%, 66% and 75%. This difference was statistically significant (chi-square test, p < 0. 05). The proportion of MCI identified in post-stroke patients was higher when using ACE-R and the MoCAin comparison to the MMSE,the ACE-R and The MoCAare recommended as an alternative in the early detection of MCI in post-stroke patients. Keywords- Strokes,Cognitive impairment, MMSE,MoCA,ACE-R. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 21-05-2018 Date of acceptance: 05-06-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Cognition is the capacity for and expression of knowledge. It represents an individual ability to gain and retain relevant information so that it can be applied in appropriate situations. Stroke is a pathology that causes alternation in conscious level and function, somatosensory dysfunctions, motor deficits, cognition, language and sleep disorders [1, 2, and 3]. Even though the stroke mortality rate has recently been decreased [4], the incidence of stroke and its consequent sequels of morbidity stay high [5]. Strokes lead to negative effects on brain structure and cognitive function [6]. The intervention in some of these effects is time sensitive , and therefore the longer a stroke goes untreated, the greater the possibility of permanent neurologic and cognitive dysfunction [7, 8]. The concept that stroke related repercussions are time sensitive does not apply to physical recovery only, but also applies to cognitive recovery [9]. Post-stroke vascular cognitive impairment (VCI) is a syndrome that rangedin severity from post-stroke vascular mild cognitive impairment (VaMCI) to dementia [10, 11]. It was mentioned that up to 92% of Stroke survivors is complicated in the early stages of recovery by cognitive impairment [12, 13]. Post-stroke VaMCI is identified by impairment in at least one cognitive domain with intact or mildly impaired instrumental activities of daily living [14]. More than half of patients with VCI (57%) are VaMCI [15, 16]. While 40% with non-disabling ischemic stroke had VaMCI [17]. Indeed, in patients with moderate neurologic recovery, cognitive impairment has recently been identified as the most persistent problem of stroke [18]. Furthermore, it is estimated that one quarter to one third of stroke patients can demonstrate dementia criteria within three months of experiencing stroke [19, 20], leading to an indirect health care costs, decreased participation in rehabilitation [21], reduced daily functional capabilities [22, 23], hospitalization and cognitive impairment [23, 24]. Then, the detection of patients with MCI, as early as possible, is crucial for the clinicians to developan appropriate treatment. This can help to recognize the patients' potentials and deficiencies, functional impairments and patient safety that could be affected by cognitive impairment [25]. It is not easy or practical to do a neuropsychological test battery early after stroke so brief CSI are required to identify patients who need further assessment. Canadian Stroke practice guidelines suggested that all patients with medically evident stroke should be screened for CI, as soon as is appropriate, and the patients who are