Perbedaan Nilai Skor Mini Mental State Examination dan Montreal Cognitive Assessment pada Tumor Otak

Abstract

Background The Mini Mental State Examination (MMSE) is the most commonly used screening test for patients but relatively insensitive compared to Montreal Cognitive Assessment (MoCA) for screening of cognitive function in brain tumor patients. Cognitive test performances are influenced by patient related variables (age, level of education) and disease-related variables (the location of the tumor, its growth rate, tumor’s size). Objective The aim of this study was to compare the proportion of the MMSE and MoCA scores in Brain Tumor patients Method A cross sectional study was conducted in 33 patients who admitted to Haji Adam Malik General Hospital with brain tumor. All of the subjects were assessed with MMSE and MoCA. Demographic data would be analyzed using descriptive statistics. To assess the difference in the propotion of patients brain tumor was used chi-square test or Fisher exact test. Results In primary brain tumor, 55% patients had abnormal MMSE score and 62,5% had abnormal MoCA score, while in secondary brain tumor 45% had abnormal MMSE score and 37,5% had abnormal MoCA score. Patients with brain tumor located in supratentorial 70% had abnormal MMSE score and 70,8% had abnormal MoCA score, and brain tumor located in infratentorial 10% had abnormal MMSE score and 12,5% had abnormal MoCA score, while in both location 20% had abnormal MMSE score and 16,7% had abnormal MoCA score. In large brain tumor patients, 85% patients had abnormal MMSE score and 87,5% had abnormal MoCA score, while in small brain tumor patients 15% had abnormal MMSE score and 12,5% had abnormal MoCA score. Patients with malignant brain tumor had abnormal MMSE score 36,4% and abnormal MoCA score 26,7%, while in benign brain tumor 63,6% had abnormal MMSE score and 73,3% had abnormal MoCA score. Conclusion There was difference proportion between MMSE and MoCA score in patients with brain tumor but no statistically significant.

Latar belakang Mini Mental State Examination (MMSE) merupakan pemeriksaan skrining yang sering digunakan, namun kurang sensitif dibandingkan Montreal Cognitive Assessment (MoCA) dalam menilai fungsi kognitif pada pasien tumor otak. Pemeriksaan fungsi kognitif dipengaruhi oleh berbagai variabel yang terkait pasien (umur, tingkat pendidikan), dan variabel-variabel yang terkait oleh penyakit (lokasi tumor, pertumbuhan tumor, ukuran tumor). Tujuan Untuk mengetahui perbedaan proporsi nilai skor MMSE dan MoCA pada pasien tumor otak Metode Studi potong lintang dengan 33 subjek tumor otak di RSUP H Adam Malik Medan. Semua pasien diperiksa dengan MMSE dan MoCA. Data demografi disajikan secara deskriptif. Untuk menilai perbedaan proporsi nilai skor MMSE dan MoCA pada tumor otak digunakan uji chi-square atau uji fisher. Hasil Pada tumor otak primer nilai skor MMSE yang terganggu 55% dan skor MoCA terganggu 62,5%, sedangkan pada tumor otak sekunder didapatkan nilai skor MMSE yang terganggu 45% dan skor MoCA yang terganggu 37,5%. Pada tumor yang berlokasi supratentorial nilai skor MMSE terganggu 70% dan skor MoCA terganggu 70,8%, dan tumor otak yang berlokasi di infratentorial nilai skor MMSE yang terganggu sebanyak 10% dan skor MoCA yang terganggu 12,5%, serta pada kedua lokasi nilai skor MMSE yang terganggu 20% dan nilai skor MoCA yang terganggu16,7%. Pada tumor ukuran besar nilai skor MMSE yang terganggu 85% dan skor MoCA terganggu 87,5%, sedangkan pada tumor ukuran kecil yang terganggu pada nilai skor MMSE 15% dan skor MoCA terganggu 12,5%. Berdasarkan pertumbuhan tumor didapatkan tumor ganas memiliki nilai skor MMSE yang terganggu 36,4% dan nilai skor MoCA terganggu 26,7%., sedangkan pada tumor otak jinak nilai skor MMSE yang terganggu 63,6% dan nilai skor MoCA yang terganggu 73,3%. Kesimpulan Terdapat perbedaan proporsi skor MMSE dan MoCA pada tumor otak namun tidak bermakna secara statistik.