Proxy consents (adult children for 4 patients, spouse for 1) were obtained in patients with dementia who lacked capacity to give informed consent. Approval from the Chinese University of Hong Kong-New Territories East Cluster Ethics Committee was obtained for the STRIDE study, and all patients gave written informed consent for participation. Patients had adequate sensorimotor and language capacity to complete cognitive testing, as determined at entry into the STRIDE study. 9 Patients with moderate or severe dementia, as defined by CDR≥2, were excluded. In the current substudy, participants were selected through stratified random sampling by cognitive status based on Clinical Dementia Rating (CDR). Patients with prestroke dementia were excluded from the STRIDE study. Participants are patients with stroke or transient ischemic attack (TIA) recruited in the ongoing STroke Registry Investigating Cognitive DEcline (STRIDE) study, 8 which is an ongoing 5-year longitudinal study to evaluate the rate and predictors of delayed cognitive decline in a consecutive cohort of 1013 patients (mean age, 69.6 years 44% women) admitted to a major regional hospital in Hong Kong for stroke and TIA between 20. The objective of this study is to examine the validity and reliability of the MoCA 5-minute protocol administered over the telephone. 4, 7 In accordance with the structure of the 5-minute protocol proposed by the NINDS-CNS Harmonization workshop, we constructed the MoCA 5-minute protocol by extracting 4 subtests from the MoCA. More than 3 abbreviations of the MoCA have been developed and examined in patients with stroke ( Table 1). It is also too lengthy (≈15 minutes) to be used as a brief screen. 3 – 6 However, its paper-and-pencil test format requires the examinee be physically present for examination. It is valid and reliable in the patients with VCI, including stroke, subarachnoid hemorrhage, and stroke-free patients with vascular risk factors. The Montreal Cognitive Assessment (MoCA) has been recommended as a clinical screening instrument for VCI. 1 The latter protocol aims to increase access for cognitive assessment for patients living in remote areas or for those not able to attend clinical follow-up for various reasons (eg, homebound) and to support telemedicine stroke service and large epidemiological and clinical research. The 60- and the 30-minute protocols were designed for detailed cognitive profiling and clinical screening, whereas a brief protocol (≈5 minutes) was proposed to serve as a screen at bedside, busy clinics, and over the telephone. In 2005, the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) VCI Harmonization Working Group recommended a set of 3 neuropsychological protocols to serve different purposes in VCI assessment.

Screening instruments for VCI should be sensitive to mild impairment and neuropsychological features of VCI. 1, 2 Cognitive assessment is integral in the diagnosis and management of VCI. It is common in the aging population and is particularly prevalent in patients with stroke. Vascular cognitive impairment (VCI) refers to cognitive dysfunction with an underlying vascular cause. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

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