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Uncharted territory: The feasibility of serial computerised cognitive assessment the first week post-stroke
Journal article   Peer reviewed

Uncharted territory: The feasibility of serial computerised cognitive assessment the first week post-stroke

Alana Campbell, Louise Gustafsson, Hannah Gullo, Mathew Summers, Ingrid Rosbergen and Rohan S Grimley
Journal of Stroke and Cerebrovascular Diseases, Vol.31(9), pp.1-10
2022
PMID: 35858514
url
https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106614View
Published Version

Abstract

CANTAB, Cambridge Neuropsychological Test Automated Battery DASS-21, Depression Anxiety Stress Scales À Short Form FSIQ, Full Scale Intelligence Quotient HREC, Human Research Ethics Committee MMSE, Mini-Mental State Examina- tion MoCA, Montreal Cognitive Assessment MTT, Multitasking Test NIHSS, National Institutes of Health Stroke Scale OCS, Oxford Cognitive Screen PAL, Paired Associates Learning RTI, Reaction Time RVP, Rapid Visual Information Processing SWM, Spatial Working Memory 4-AT4-A's Test for Delirium WTARWechsler Test of Adult Reading
Background: Cognitive impairment is common and problematic post-stroke, yet vital information to understand early cognitive recovery is lacking. To examine early cognitive recovery, it is first necessary to establish the feasibility of repeat cognitive assessment during the acute post-stroke phase. Objective: To determine if serial computerised testing is feasible for cognitive assessment in an acute post-stroke phase, measured by assessment completion rates. Method: An observational cohort study recruited consecutive stroke patients admitted to an acute stroke unit within 48 hours of onset. Daily assessment with the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed for seven days, and single Montreal Cognitive Assessment (MoCA). Results: Seventy-one participants were recruited, mean age 74 years, with 67 completing daily testing. Participants had predominantly mild (85%; NIHSS ≤6), ischemic (90%) stroke, 32% demonstrated clinical delirium. The first day of testing, 76% of participants completed CANTAB batteries. Eighty-seven percent of participants completed MoCA a mean of 3.4 days post-stroke. The proportion of CANTAB batteries completed improved significantly from day 2 to day 3 post-stroke with test completion rates stabilizing ≥ 92% by day 4. Participants with incomplete CANTAB were older, with persisting delirium, and longer stay in acute care. Conclusion: Serial computerised cognitive assessments are feasible the first week post-stroke and provide a novel approach to measuring cognitive change for both clinical and research purposes. Maximum completion rates by day four have clinical implications for optimal timing of cognitive testing.

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Web Of Science research areas
Neurosciences
Peripheral Vascular Disease

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