1/17/2024 0 Comments Moca blind cut off scores![]() Incorporates part of the Cambridge Examination for Mental Disorders of the Elderly and MMSE 67 clinician-administered pencil-and-paper and verbal items assess orientation and attention, language, memory, praxis, calculation, abstraction and perception. Incorporates the MMSE.Ĭlinicians assess alertness, basic language and cooperation If intact, 27 pencil-and-paper and verbal items assess orientation and attention, memory, awareness, language, visuospatial problem-solving and affect. Brief description of each identified measure meeting psychometric criteria in at least one validation studyĢ6 clinician-rated pencil-and-paper and verbal tasks assess orientation and attention, memory, language, verbal fluency and visuospatial skills. All tools screening for “any impairment” or multi-domain impairments used a neuropsychological assessment (31–33, 36-38, 40–44, 46, 48, 49), while dementia screening tools were compared with a clinical diagnosis based on neuropsychological and clinical assessment, discussion with an informant and Diagnostic and Statistical Manual (DSM) criteria (34, 35, 39, 41, 45, 47, 49–51). Several criterion measures were used as the reference gold-standard. Two further studies assessed participants at 3–9 months post-stroke (50, 51). Four papers considered long-term cognitive impairment (more than 6 months) (31, 32, 46, 49). Most studies recruited from acute in-patient settings (32–42), although some recruited rehabilitation in-patients (43–45) and out-patients attending clinics or day hospitals (46–48). Most studies primarily included participants with stroke or transient ischaemic attack, whilst others were more specific and only included people with subarachnoid haemorrhage (32) or lacunar infarcts (33, 34). These are described in Table I and the populations tested are detailed in Table II. Twenty-one selected papers assessed the 12 remaining screening tools involving 2,148 stroke survivors. Four tools had only been validated against other screening tools (Addenbrooke’s Cognitive Examination-Revised 9-item (22) Intelligent Cognitive Assessment System (23) National Institute of Neurological Disorders and Stroke-Canadian Stroke Network ‘short MoCA’ (24) new short Montreal Cognitive Assessment (25)) and a further 6 did not reach the sensitivity and specificity criteria at any cut-off scores (Abbreviated Mental Test (26), COG-4 (27), Middlesex Elderly Assessment of Mental State (28), Modified Mini Mental State (29), Standardised-Mini Mental State Examination (30), Telephone-Montreal Cognitive Assessment-short (31)). Eighteen tools did not meet the selection criteria: 8 were not developed to screen for overall cognitive impairment, or did not cover at least 3 domains (4 A Test (14), Abbreviated Mental Test-4 item (15), Clock Drawing Test (16), Kaufman Short Neuropsychological Assessment Procedure Impairment Index (17), Mattis Dementia Rating Scale – Initiation-Perseveration subscale (18), Preliminary Neuropsychological Battery (19), Screening Instrument for Neuropsychological Impairments in Stroke (20), Weigl Colour-Form Sorting Test (21)). Tools scoring < 6 were rejected at this stage. Scores were summed to give a maximum of 6 points higher scores indicate greater clinical utility. need for specialist training to administer and score the measure: 1 = minimal training required 0 = specialist training required.additional cost per record form: 1 = no additional costs 0 = additional cost or unavailable.starter kit including manual): 2 = freely available 1 = cost of < £100 0 = cost of ≥ £100 or unavailable initial costs for purchase of the measure (e.g.Clinical utility was assessed using a previously validated tool and those scoring 20 min Tools with sensitivity ≥ 80% and specificity ≥ 60% were selected. ![]() STUDY SELECTION:Studies testing the accuracy of screening tools for cognitive impairment after stroke.ĭATA EXTRACTION:Data regarding the participants, selection criteria, criterion/reference measure, cut-off score, sensitivity, specificity and positive and negative predicted values for the selected tools were extracted. OBJECTIVE: To systematically review the psychometric properties and clinical utility of cognitive screening tools post-stroke.ĭATA SOURCES: EMBASE, CINAHL, MEDLINE, PsychInfo.
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