Telephone-based cognitive screening for stroke patients in China

Area of Science:

• Neurology
• Neuropsychology
• Telemedicine

Background:

• Cognitive impairment is a common and significant issue following stroke.
• Existing telephone assessments for cognitive impairment in stroke patients are limited.
• The 5-minute National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) protocol and the six-item screener (SIS) are potential tools for remote cognitive assessment.

Purpose of the Study:

• To evaluate the feasibility and validity of telephone administration of the 5-minute NINDS-CSN protocol and SIS for cognitive impairment screening in stroke patients.
• To determine the accuracy of these telephone-based assessments compared to comprehensive face-to-face evaluations.

Main Methods:

• Eighty-nine stroke patients underwent a comprehensive face-to-face neuropsychological assessment.
• Subsequently, 80 patients completed telephone assessments using the 5-minute NINDS-CSN protocol and SIS.
• Administration time was recorded, and validity was assessed using the area under the receiver operating characteristics curve (AUC).

Main Results:

• Telephone administration of the 5-minute NINDS-CSN protocol took 4.3 ± 1.0 minutes, and SIS took 57.3 ± 17.7 seconds.
• The AUC for detecting cognitive impairment was 0.86 for the 5-minute NINDS-CSN protocol and 0.74 for SIS.
• Optimal cut-off values were identified as 23.5/24 for the 5-minute NINDS-CSN protocol and 4/5 for SIS.

Conclusions:

• The telephone-based 5-minute NINDS-CSN protocol and SIS are feasible and valid tools for screening cognitive impairment in stroke patients.
• These methods offer a practical approach to remote cognitive assessment in post-stroke care, particularly in settings like China.