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Prediction of post-stroke dementia using NINDS-CSN 5-minute neuropsychology protocol in acute stroke

Published online by Cambridge University Press:  25 January 2017

Jae-Sung Lim Open the ORCID record for Jae-Sung Lim [Opens in a new window] ,
Mi Sun Oh ,
Ju-Hun Lee ,
San Jung ,
Chulho Kim ,
Min Uk Jang ,
Sang-Hwa Lee ,
Yeo Jin Kim ,
Yerim Kim  and
Jaeseol Park
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Jae-Sung Lim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Mi Sun Oh
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Ju-Hun Lee
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
San Jung
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Chulho Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Min Uk Jang
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Sang-Hwa Lee
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yeo Jin Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yerim Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Jaeseol Park
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yeonwook Kang
Affiliation:
Department of Psychology, Hallym University College of Social Sciences, Chuncheon, Republic of Korea
Kyung-Ho Yu*
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Byung-Chul Lee*
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
*
Kyung-ho Yu, MD. PhD, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 17beon-gil, Dongan-gu, Anyang 14068, Republic of Korea. Phone: +82-31-380-3743; Fax: +82-31-380-4659. E-mail: ykh1030@hallym.or.kr
Correspondence should be addressed to: Byung-Chul Lee, MD, PhD, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 17beon-gil, Dongan-gu, Anyang 14068, Republic of Korea. Phone: +82-31-380-3740; Fax: +82-31-380-4659. Email: ssbrain@hallym.ac.kr.
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Abstract

Background:

The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.

Method:

We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.

Results:

Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).

Discussion:

The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.

Keywords

post-stroke dementiavascular cognitive impairmentmontreal cognitive assessmentcerebral infarction
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 5 , May 2017 , pp. 777 - 784
Copyright
Copyright © International Psychogeriatric Association 2017 

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