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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
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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: [email protected].
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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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