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Published on: December 16, 2022
Utility of a Computerized Cognitive Function Assessment Tool (CogEvo) in Patients With Acute Stroke: Associations
Keiichiro Aoki1, Takeaki Miyata2, Akihiro Iguchi2
1Department of Occupational Therapy, School of Rehabilitation, Tokyo Professional University of Health Sciences, Tokyo, JPN.
Background:
Cognitive impairment is a common and clinically significant consequence of acute stroke, frequently associated with prolonged hospitalization and poor functional outcomes. Conventional paper-based tools such as the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) have recognized limitations in the acute setting, including ceiling effects and high rates of non-completion. CogEvo, a tablet-based computerized cognitive assessment tool evaluating five domains (orientation, attention, memory, planning, and spatial cognition), offers a potentially feasible alternative; however, its applicability in acute stroke has not been established.
Methods:
In this prospective single-center pilot study, 17 consecutive acute stroke patients underwent concurrent CogEvo, MMSE, and TMT-A/B assessments during occupational therapy evaluation (mean 13.9 ± 7.5 days post-admission). Spearman rank-order correlations were computed between CogEvo composite and domain scores and MMSE, length of hospital stay, TMT-A/B, National Institutes of Health Stroke Scale (NIHSS), and age. TMT analyses used separate complete case analyses (TMT-A: N = 12; TMT-B: N = 10).
Results:
All 17 patients completed CogEvo; only 10 (58.8%) completed TMT-B. CogEvo composite scores were significantly correlated with MMSE (r = 0.693, p = 0.002), length of hospital stay (r = -0.518, p = 0.033), TMT-A (r = -0.580, p = 0.048, N = 12), and TMT-B (r = -0.648, p = 0.043). Domain-level analyses (N = 14) revealed that attention (r = 0.633, p = 0.015), planning (r = 0.668, p = 0.009), and spatial cognition (r = 0.664, p = 0.010) were significantly correlated with MMSE; planning was also significantly correlated with length of hospital stay (r = -0.641, p = 0.014).
Conclusions:
CogEvo demonstrated universal feasibility, convergent validity with MMSE and TMT, and clinically meaningful associations with length of hospital stay in acute stroke patients. Domain-level analyses suggest that planning ability may be particularly relevant to the discharge trajectory. CogEvo may serve as a feasible ICT-based complement to conventional cognitive assessment in the acute stroke setting. Prospective multicenter studies are warranted.
