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VasCog Screen test: sensitive in detecting cognitive impairment in patients who had a stroke or with heart failure
Nicole Yun Ching Chen1, Melissa Yi Ling Tan2, Jing Xu3
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
A new screening tool, the VasCog Screen, effectively detects cognitive impairment in stroke and heart failure patients. This test shows high accuracy, aiding early intervention for vascular cognitive impairment.
Area of Science:
- Neurology
- Cardiology
- Psychology
Background:
- Vascular diseases like stroke and heart failure (HF) are linked to cognitive decline.
- Vascular cognitive impairment (CI) affects stroke and HF patients, ranging from mild impairment to dementia.
- Early CI detection is vital for managing stroke and HF patients.
Purpose of the Study:
- To develop the VasCog Screen, a tool for identifying CI in stroke and HF patients.
- To assess the efficacy of the VasCog Screen compared to existing cognitive tests.
Main Methods:
- 427 stroke and HF patients were evaluated using cognitive tests (MMSE, MoCA, neuropsychological battery).
- The VasCog Screen was developed by combining a short Montreal Cognitive Assessment (short-MoCA) with the Symbol Digit Modalities Test (SDMT).
- Discriminatory abilities and optimal cut-off points for CI detection were determined.
Main Results:
- Cognitive impairment was prevalent in over half of the stroke and HF patients.
- Visuomotor speed deficits were most common, followed by visual memory and visuoconstruction impairments.
- The VasCog Screen demonstrated superior performance in detecting CI compared to MMSE, MoCA, and short-MoCA, with SDMT enhancing diagnostic accuracy.
Conclusions:
- The VasCog Screen is a sensitive and specific tool for detecting characteristic cognitive deficits in stroke and HF patients.
- The test exhibits good classification accuracy and is easily administered in clinical settings.
- Early CI detection with VasCog Screen facilitates timely interventions for improved patient outcomes.
Introduction:
Vascular diseases, such as stroke and heart failure (HF), are associated with cognitive decline. Vascular cognitive impairment (CI) is commonly found in patients who had a stroke and with HF, ranging from mild CI to dementia. Early detection of CI is crucial for effective management and rehabilitation. This study aimed to develop the VasCog Screen test, a screening tool to detect CI in patients who had a stroke and with HF.
Method:
427 patients who had a stroke and with HF were assessed using cognitive measures including Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery. The short-MoCA was derived and combined with Symbol Digit Modalities Test (SDMT) to create the VasCog Screen. The discriminatory ability of different tests for CI was compared, establishing optimal cut-off points. Variants of short-MoCA including the SDMT were also evaluated.
Results:
Similar prevalence rates of CI were found in stroke and HF cohorts. The most prevalent neuropsychological impairment was visuomotor speed, followed by visual memory and visuoconstruction. More than half of the patients were found to have CI. The VasCog Screen outperformed MMSE, MoCA and short-MoCA in detecting CI. The addition of SDMT to variants of the short-MoCA increased diagnostic accuracy.
Conclusion:
The VasCog Screen test offers a cognitive screening tool, which is sensitive to cognitive deficits characteristically found in patients who had a stroke and with HF. It was found to have good sensitivity, specificity and classification accuracy. It is easy to administer in busy clinics, enabling early detection of CI and facilitating appropriate interventions.
