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Telephone-based cognitive screening for stroke patients in china

Published online by Cambridge University Press:  17 April 2015

Xiangliang Chen ,
Xinying Fan ,
Lingling Zhao ,
Lihui Duan ,
Zhaojun Wang ,
Yunfei Han ,
Qiliang Dai ,
Dezhi Liu ,
Xiaohao Zhang  and
Zhonglun Chen
...Show all authors
Xiangliang Chen
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Xinying Fan
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Lingling Zhao
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Lihui Duan
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Zhaojun Wang
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Yunfei Han
Affiliation:
Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China
Qiliang Dai
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Dezhi Liu
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Xiaohao Zhang
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Zhonglun Chen
Affiliation:
Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China
Yunyun Xiong
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
Xinfeng Liu*
Affiliation:
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
*
Correspondence should be addressed to: Prof. Xinfeng Liu Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China. Phone: 86-25-84801861; Fax: 86-25-84866453. Email: xfliu2@vip.163.com.
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Abstract

Background:

Valid telephone assessment for cognitive impairment is lacking in stroke settings. We investigated the feasibility and validity of the 5-minute National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) protocol and six-item screener (SIS) in stroke patients by telephone administration.

Methods:

Patients were assessed with a comprehensive face-to-face neuropsychological assessment after three months of stroke onset, followed by the 5-minute NINDS-CSN protocol (30 points) and SIS (6 points) at least one month later. Administration time was recorded for the telephone tests. Validity of both tests was determined using the area under the receiver operating characteristics curve (AUC).

Results:

Eighty-nine patients (age, 62.9 ± 8.6 years; male, 65.2%) received a face-to-face assessment and 80 completed telephone tests. The time required to administer the 5-minute NINDS-CSN protocol was 4.3 ± 1.0 minutes, and SIS 57.3 ± 17.7 seconds. Validity of detecting cognitive impairment as assessed by AUC was 0.86 (95% CI, 0.78–0.94) for 5-minute NINDS-CSN protocol, and 0.74 (95% CI, 0.63–0.85) for SIS. Sensitivity and specificity were optimal with the cut-off values of 23.5/24 for the 5-minute NINDS-CSN protocol, and 4/5 for SIS.

Conclusions:

Both the telephone-based 5-minute NINDS-CSN protocol and SIS were feasible and valid in screening cognitive impairment after stroke in China.

Keywords

cognitive impairmentstrokesix-item screenerMontreal cognitive assessmenttelephone assessmentneuropsychologyvalidation studyChina
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 12 , December 2015 , pp. 2079 - 2085
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Benedict, R. H. B., Schretlen, D., Groninger, L. and Brandt, J. (1998). Hopkins verbal learning test – revised: normative data and analysis of inter-form and test-retest reliability. The Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Section D), 12, 43–55. doi: 10.1076/clin.12.1.43.1726.CrossRefGoogle Scholar
Callahan, C. M., Unverzagt, F. W., Hui, S. L., Perkins, A. J. and Hendrie, H. C. (2002). Six-item screener to identify cognitive impairment among potential subjects for clinical research. Medical Care, 40, 771–781. doi: 10.1097/01.MLR.0000024610.33213.C8.CrossRefGoogle ScholarPubMed
Castanho, T. C., Amorim, L., Zihl, J., Palha, J. A., Sousa, N. and Santos, N. C. (2014). Telephone-based screening tools for mild cognitive impairment and dementia in aging studies: a review of validated instruments. Frontiers in Aging Neuroscience, 6, 1–17. doi: 10.3389/fnagi.2014.00016.Google Scholar
Chen, M. R., Guo, Q. H., Cao, X. Y., Hong, Z. and Liu, X. H. (2010). A preliminary study of the six-item screener in detecting cognitive impairment. Neuroscience Bulletin, 26, 317–321. doi: 10.1007/s12264-010-0106-1.CrossRefGoogle ScholarPubMed
Chen, X. L. et al. (2015). Validation of NINDS-CSN neuropsychological battery for vascular cognitive impairment in Chinese stroke patients. BMC Neurology, 15, 1–6. doi: 10.1186/s12883-015-0270-z.CrossRefGoogle ScholarPubMed
Corwin, J. and Bylsma, F. W. (1993). Psychological examination of traumatic encephalopathy. Clinical Neuropsychologist, 7, 3–21. doi: 10.1080/13854049308401883.Google Scholar
Dong, Y. et al. (2014). Improving screening for vascular cognitive impairment at three to six months after mild ischemic stroke and transient ischemic attack. International Psychogeriatrics, 26, 787–793. doi: 10.1017/s1041610213002457.Google Scholar
Douiri, A., Rudd, A. G. and Wolfe, C. D. (2013). Prevalence of poststroke cognitive impairment: South London Stroke Register 1995–2010. Stroke, 44, 138–145. doi: 10.1161/STROKEAHA.112.670844.Google Scholar
Franzen, M. D., Haut, M. W., Rankin, E. and Keefover, R. (1995). Empirical comparison of alternate forms of the Boston naming test. The Clinical Neuropsychologist, 9, 225–229. doi: 10.1080/13854049508400484.Google Scholar
Fuh, J. L. et al. (1995). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology, 45, 92–96. doi: 10.1212/WNL.45.1.92.Google Scholar
Grzybowski, M. and Younger, J. G. (1997). Statistical methodology: III. Receiver operating characteristic (ROC) curves. Academic Emergency Medicine, 4, 818–826. doi: 10.1111/j.1553-2712.1997.tb03793.x.Google Scholar
Hachinski, V. et al. (2006). National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke, 37, 2220–2241. doi: 10.1161/01.STR.0000237236.88823.47.Google Scholar
Hanley, J. A. and McNeil, B. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 143, 29–36. doi: 10.1148/radiology.143.1.7063747.Google Scholar
Isaacs, B. and Kennie, A. T. (1973). The set test as an aid to the detection of dementia in old people. The British Journal of Psychiatry, 123, 467–470. doi: 10.1192/bjp.123.4.467.Google Scholar
Kennedy, R. E. et al. (2014). Performance of the NINDS-CSN 5-minute protocol in a national population-based sample. Journal of the International Neuropsychological Society, 20, 856–867. doi: 10.1017/s1355617714000733.Google Scholar
Koga, M. et al. (2005). The existence and evolution of diffusion-perfusion mismatched tissue in white and gray matter after acute stroke. Stroke, 36, 2132–2137. doi: 10.1161/01.STR.0000181066.23213.8f.Google Scholar
Lange, E. B. and Oberauer, K. (2005). Overwriting of phonemic features in serial recall. Memory, 13, 333–339. doi: 10.1080/09658210344000378.Google Scholar
Pendlebury, S. T., Welch, S. J., Cuthbertson, F. C., Mariz, J., Mehta, Z. and Rothwell, P. M. (2013). Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal cognitive assessment versus face-to-face Montreal cognitive assessment and neuropsychological battery. Stroke, 44, 227–229. doi: 10.1161/STROKEAHA.112.673384.Google Scholar
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276. doi: 10.2466/PMS.8.7.271-276.Google Scholar
Sibolt, G. et al. (2013). Poststroke dementia is associated with recurrent ischaemic stroke. Journal of Neurology, Neurosurgery & Psychiatry, 84, 722–726. doi: 10.1136/jnnp-2012-304084.Google Scholar
Sivakumar, L., Kate, M., Jeerakathil, T., Camicioli, R., Buck, B. and Butcher, K. (2014). Serial Montreal cognitive assessments demonstrate reversible cognitive impairment in patients with acute transient ischemic attack and minor stroke. Stroke, 45, 1709–1715. doi: 10.1161/STROKEAHA.114.004726.Google Scholar
Velayudhan, L. et al. (2014). Review of brief cognitive tests for patients with suspected dementia. International Psychogeriatrics, 26, 1247–1262. doi: 10.1017/s1041610214000416.Google Scholar
Wadley, V. G. et al. (2011). Incident cognitive impairment is elevated in the stroke belt: the REGARDS study. Annals of Neurology, 70, 229–236. doi: 10.1002/ana.22432.Google Scholar
Wechsler, D. (1997). WAIS-III Administration and Scoring Manual. New York: The Psychological Corporation.Google Scholar
Wilson, K. G. (1984). Psychophysiological activity and the buildup and release of proactive inhibition in short-term memory. Psychophysiology, 21, 135–142. doi: 10.1111/j.1469-8986.1984.tb00195.x.CrossRefGoogle ScholarPubMed
Wong, A. et al. (2013). The NINDS-Canadian stroke network vascular cognitive impairment neuropsychology protocols in Chinese. Journal of Neurology Neurosurgery and Psychiatry, 84, 499–504. doi: 10.1136/jnnp-2012-304041.Google Scholar
Yang, G. et al. (2013). Rapid health transition in China, 1990–2010: findings from the global burden of disease study 2010. Lancet, 381, 1987–2015. doi: 10.1016/s0140-6736(13)61097-1.Google Scholar
Yu, K. H. et al. (2013). Cognitive impairment evaluated with vascular cognitive impairment harmonization standards in a multicenter prospective stroke cohort in Korea. Stroke, 44, 786–788. doi: 10.1161/strokeaha.112.668343/-/dc1.Google Scholar