Predicting Cognitive Rehabilitation Needs in Patients with Central Nervous System Infections Using Montreal Cognitive Assessment

Cognitive impairments are reported in some patients with central nervous system (CNS) infections after discharge. Our objectives were to evaluate the prevalence of CNS patients in need of rehabilitation after discharge and to assess whether the Montreal Cognitive Assessment (MoCA) could be used as a screening tool to identify these patients. CNS patients admitted during a 2-year study period were included. The need for rehabilitation was assessed by physicians with the aid of an occupational therapy assessment, after which a MoCA was performed. The prevalence of needing rehabilitation was 58% among CNS patients. An abnormal MoCA score < 26 was the only variable strongly associated with higher odds of needing rehabilitation. In 42% of the CNS patients in need of rehabilitation, the MoCA score was ≥ 26, and most of these patients were aged 16 to 43 years (young adults). There is a need for rehabilitation among CNS patients after discharge. As a screening tool, MoCA was able to identify patients in need of rehabilitation. In young adults, MoCA scores were often normal despite a need for rehabilitation. Thus, MoCA cannot stand alone as a screening tool for identifying young adults in need of rehabilitation following CNS infection.