Article

OBJECTIVE: To systematically review the psychometric properties and clinical
utility of cognitive screening tools post-stroke. DATA SOURCES: EMBASE, CINAHL,
MEDLINE, PsychInfo. STUDY SELECTION: Studies testing the accuracy of screening
tools for cognitive impairment after stroke. DATA EXTRACTION: Data regarding the
participants, selection criteria, criterion/reference measure, cut-off score,
sensitivity, specificity and positive and negative predicted values for the
selected tools were extracted. Tools with sensitivity >/= 80% and specificity >/=
60% were selected. Clinical utility was assessed using a previously validated
tool and those scoring < 6 were excluded. DATA SYNTHESIS: Twenty-one papers
regarding 12 screening tools were selected. Only the Montreal Cognitive
Assessment (MoCA) and Mini Mental State Examination (MMSE) met all psychometric
and clinical utility criteria for any levels of cognitive impairment. However,
the MMSE is most accurate to screen for dementia (cut-off score 23/24) and should
only be used for this purpose. In addition, the following can be used to detect:
* Any impairment: Addenbrooke's Cognitive Examination-Revised (ACE-R), Barrow
Neurological Institute Screen for Higher Cerebral Functions (BNIS) and Cognistat.
* Multiple-domain impairments: ACE-R, Telephone-MoCA or modified Telephone
Interview for Cognitive Status (TICS). * Dementia: TICS; Cambridge Cognitive
Examination; Rotterdam-Cambridge Cognitive Examination; Informant Questionnaire
for Cognitive Decline in the Elderly (IQCODE) and short-IQCODE.
The IQCODE and
short-IQCODE are useful when the patient is unable to respond and an informant's
view is required. CONCLUSION: The MoCA is the most valid and clinically feasible
screening tool to identify stroke survivors with a wide range of cognitive
impairments who warrant further assessment.

Langue : ANGLAIS