Abstract
Objective Two million adults under fifty years of age have a cerebral stroke every year worldwide. Neuropsychological assessment is the best way to identify poststroke cognitive dysfunction, but it is often time-consuming and can be tiring for the patient, and hospitals vary in their availability of neuropsychological expertise. A valid and reliable cognitive screening method could be advantageous in identifying patients who need comprehensive neuropsychological examination. Our purpose in this study was to validate a newly developed cognitive screening method as an identifier of cognitive dysfunction after stroke in working-aged patients. Methods We analyzed new cognitive screening method concurrent validity by comparing it in two groups formed on the basis of a comprehensive neuropsychological examination for 77 stroke patients. We identified the best balance of sensitivity and specificity by using receiver operating characteristic curve analysis and investigated the impact of the sociodemographic variables to the screening method total score variation. Results We found a significant correlation between the method's total score and performance in neuropsychological examination. The cognitive method's internal consistency was strong; Cronbach's alpha for all items was .818. The best balance of sensitivity (88%) and specificity (50%) was found at a total score cut point of 138. Subjects' age and length of education were each responsible for 10% of total score variation. Conclusions This study shows promising results for this new cognitive screening tool's ability to identify poststroke cognitive decline and patients' need for further detailed neuropsychological examination.
Highlights
Every year, about two million adults under fifty years of age worldwide suffer from a stroke
Studies have shown that the prevalence of cognitive problems varies from 40% to over 90% depending on the definition of cognitive dysfunction [1, 2]
Neurologists evaluated each patient using the following criteria: the patient fit the criteria of the research study if he/she was under 69 years of age, was employed at the time of the onset of stroke, and had the opportunity to return to work after sick leave
Summary
About two million adults under fifty years of age worldwide suffer from a stroke. Identification and recognition of cognitive deficits caused by stroke is important for organizing adequate rehabilitation programs and for preventing and delaying further poststroke symptoms [5]. Cognitive dysfunction may stay unrecognized and become evident only after the patient returns to social and occupational activities, which might cause significant social and emotional distress [6, 7]. Routine cognitive screening for poststroke patients would help clinicians and patients to detect and diagnose cognitive deficits [8]. Neuropsychological assessment is the best way to identify poststroke cognitive dysfunction [1, 9], but it takes time and is tiring for the patient, especially at the acute stage of stroke [10]. The aim of the present study is to develop a brief screening method that would be easy to administer and interpret by nonneuropsychological health care professionals and would serve in identifying
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