The NIH Stroke Scale Can Establish Cognitive Function after Stroke (original) (raw)
Related papers
Stroke research and treatment, 2013
Background. Assessing poststroke cognitive impairment is complex. A subscale of the NIHSS, the Cog-4, has been proposed as a quick test of "cognitive impairment." but a study of its properties in a larger dataset is lacking. Methods. Data from 9,147 patients with acute stroke from the VISTA archive was used to generate Cog-4 scores. The statistical properties of Cog-4, its relationship with baseline clinical characteristics, and other functional outcome measures at day 90 were assessed. Results. Mean age of patients was 69.2 years and 45.8%, were females. Day-90 Cog-4 was highly positively skewed (skewness 0.926). Patients with left hemispheric stroke had higher day-90 Cog-4 score (P < 0.001). Age, stroke severity, and previous stroke were significant predictors of Cog-4. Cog-4 was significantly correlated with dependency (modified Rankin Scale, r s = 0.512), and disability (Barthel Index, r s = -0.493). Conclusions. The Cog-4 scale at day 90 cannot be considered a usef...
Can the stroke impact scale 3.0 detect cognitive impairments in patients with a recent stroke?
Journal of Physical Therapy Science
The aim of this study was to identify cognitive impairments in patients with a recent stroke using Stroke Impact Scale 3.0 (SIS). [Participants and Methods] A retrospective cohort study was conducted to evaluate 50 medical records in patients with a recent stroke who have completed a stroke rehabilitation programme. All data were evaluated at St. Finbarr's Hospital in Cork, Ireland. [Results] A total of 41 records met the inclusion criteria, of which 53.7% were male. Regarding the risk factors, most patients complained of hypertension (85.4%), with most being diagnosed with embolic stroke (56.1%). The SIS identified numerous issues in stroke patients, such as persistent problems with memory (36.6%), concentration (29.3%), and solving everyday problems (43.9%). In addition, some patients' responses were negative regarding their emotion such as feeling sad (51.2%), not enjoying things as much as ever (39%), feeling life is not worth living (85.4%) and not smiling or laughing at least once a day (80.5%). [Conclusion] The inclusion of the SIS in the stroke review clinic identified cognitive deficits that may not have otherwise been detected. By using SIS in a systematic and standardised way, deficits can be identified, and appropriate rehabilitation can be provided.
Assessment of level of cognitive impairment among stroke patients
It was estimated that yearly 20 million people are affected with stroke, among them five million die. Cognitive impairment occurs in about two third of stroke survivors. Several studies reported that the impaired cognition hampers the level of patient role in his self-care and also a major determinant of caregivers role.
Development and validation of ‘Cognitive Assessment Scale for Stroke Survivors’
Anaesthesia, Pain & Intensive Care
Background & Objectives: Stroke is a leading cause of death and it causes significant long-term disabilities. It affects cognition and physical impairment in the patients. Cognitive impairments caused by stroke include loss of memory, disorientation, impaired attention, reasoning, and social perception. It may also lead to interaction deficit and inability to problem-solving, etc. The precise knowledge about the degree of cognitive impairment is essential to address the issue with appropriate measures. We aimed to develop a cognitive measurement scale for stroke patients. Methodology: The phenomenon was explored through in-depth interviews of 12 stroke survivors in different hospitals in Lahore, Pakistan. Seventeen items were generated. After factor analysis, 15 items were included in the scale and a pilot study was conducted on 15 participants. A sample of 106 patients was selected to administer the scale Cognitive Assessment Scale for Stroke Survivors (CASS) and Mini-Mental State ...
Screening for cognitive deficits after stroke: a comparison of three screening tools
Clinical Rehabilitation, 2008
Objective: To assess the concurrent validity of three screening tests for focal cognitive impairments after stroke. Design: Comparison of results from the screening tests with those from a more comprehensive neuropsychological battery. Setting: Stroke rehabilitation wards of a general hospital and a rehabilitation hospital. Subjects: Forty-nine stroke patients (25-91 years, 35% women). Measures: Screening tests were the Cognistat, the Screening Instrument for Neuropsychological Impairments in Stroke (SINS) and the Clock Drawing Test. Health professionals, blind to the results of the reference method, did the screening. Reference method was a neuropsychological assessment based on the Norwegian Basic Neuropsychological Assessment, classifying the patients as 'impaired' or 'not impaired' within the following cognitive domains: language, visuospatial function, attention and neglect, apraxia, speed in unaffected arm, and memory. Results: The best sensitivity (95% confidence interval) was achieved for language problems by Cognistat, naming (80%, 44-98); for visuospatial dysfunction, attention deficits and reduced speed, all by SINS visuocognitive (82%, 60-95, 72%, 39-94, and 78%, 56-93, respectively); and for memory problems by Cognistat memory (69%, 52-87). The data were insufficient to assess any subtest for apraxia. Sensitivity in detecting deficits in any domain was 82% (71-94) for the Cognistat composite score, 71% (57-85) for the SINS composite score, and 63% (49-78) for the most sensitive score of the Clock Drawing Test. Conclusion: The Cognistat and the SINS may be used as screening instruments for cognitive deficits after stroke, but cannot replace a neuropsychological assessment. The Clock Drawing Test added little to the detection of cognitive deficits.
International journal of geriatric psychiatry, 2016
Cognitive screening is recommended in stroke, but test completion may be complicated by stroke related impairments. We described feasibility of completion of three commonly used cognitive screening tools and the effect on scoring properties when cognitive testing was entirely/partially incomplete. We performed a cross-sectional study, recruiting sequential stroke patient admissions from two University Hospital stroke rehabilitation services. We assessed Folstein's mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and Addenbrooke's cognitive examination (ACE-III). The multidisciplinary team gave an independent diagnostic formulation. We recorded numbers fully/partially completing tests, assistance and time required for testing. We calculated test discrimination metrics in relation to clinical assessment using four differing statistical approaches to account for incomplete testing. We recruited 51 patients. Direct assistance to complete cognitive tests...
The Oxford Cognitive Screen (OCS): Validation of a stroke-specific short cognitive screening tool
Psychological Assessment, 2015
There is currently no existing freely available short screen for cognitive problems that targets stroke survivors specifically. We have developed a short cognitive screen, the Oxford Cognitive Screen (OCS), to be completed in 15-20 min, designed for use with stroke patients. To maximize inclusion, the test is aphasia-and neglect friendly and covers domains of cognition where deficits frequently occur after stroke, including apraxia and unilateral neglect as well as memory, language, executive function, and number abilities. Domain-specific scores are returned to help direct rehabilitation. This article presents the normative data in a large sample of 140 neurologically healthy participants, a report on incidences of impairments in a sample of 208 acute stroke patients (within 3 weeks of stroke onset), measures of test-retest reliability on an alternate form and convergent and divergent validity. In addition, the full test materials are made freely available for clinical use.
Frontiers in neurology, 2018
The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification an...
Construct validity of the NIH Toolbox Cognition Battery in individuals with stroke
Rehabilitation psychology, 2017
The National Institutes of Health (NIH) Toolbox (NIHTB) for the Assessment of Behavior and Neurological Function Cognition Battery (NIHTB-CB) provides a brief assessment (approximately 30 min) of key components of cognition. This article examines construct validity to support the clinical utility of the NIHTB-CB in individuals with stroke. A total of 131 individuals with stroke (n = 71 mild stroke; n = 60 moderate/severe stroke) completed the NIHTB-CB. Univariate analyses were conducted to examine the cognitive profiles of the two different stroke groups (mild vs. moderate/severe stroke) on NIHTB-CB measures and composite scores. Pearson correlations were conducted between NIHTB-CB and established measures to examine convergent and discriminant validity. Effect sizes and clinical impairment rates for the different NIHTB-CB measures and composite scores were also examined. Participants experiencing moderate to severe stroke had poorer performance than did individuals with mild stroke...