Issue №2-22, 2023

Original article

https://doi.org/10.38025/2078-1962-2023-22-2-32-41

Psychometric Approbation of Screening Methods for the Diagnosis of Cognitive Status in a Sample of Ischemic Stroke Patients: an Observational Cohort Study

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1 ORCID Anastasia V. Kotelnikova 1 ORCID Irena V. Pogonchenkova 1,2 ORCID Elena V. Kostenko 1 ORCID Liudmila V. Petrova 1 ORCID Anna V. Khaustova

1Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department
2Pirogov Russian National Research Medical University


ABSTRACT

INTRODUCTION. Cognitive disorders (CD) are the leading causes of disability and worsening of the quality of life of after-stroke patients. An important task is the validation of the scales for screening and diagnosis of CD.

AIM. To estimate the validity of screening methods for measuring cognitive functions (MMSE, МоСА) on a sample of patients with ischemic stroke (IS).

MATERIAL AND METHODS. We examined 105 patients with IS (stroke duration 2.7 ± 1.9 months) and studied various types of validity, reliability and differentiating capabilities of test scales. As an external criterion, the data of the methodology «Brief neuropsychological Cognitive examination (BNCE)» were used. The conditions of applicability of the tests were investigated by comparative analysis of data with patients of the comparison group (n = 100) with diseases of the musculoskeletal system.

RESULTS. The МоСА and MMSE tests had high indicators of substantive validity and internal consistency of the scales (α-Kronbach: 0.95 for МоСА and 0.92 for MMSE). The discriminative capabilities of the techniques are limited: there are discrepancies in the screening results compared to the BNCE data: МоСА tends to overdiagnose pronounced cognitive impairment (CI), MMSE showed low sensitivity to pronounced CI and a tendency to overestimate the number of cases of absence of CI. The revision of the test standards was justified by direct extrapolation of the boundaries of the quantitative interpretation of various levels of CI according to the BNCE to the tested scales and showed high competitive capabilities of the МоСА in the screening study of cognitive status.

CONCLUSION. Various types of validity and reliability of scales were studied, the method of quantitative interpretation was modified, and new test standards for MMSE and MoCA were developed. The high prognostic capabilities of the МоСА for studying of cognitive functions in patients after IS allow us to consider it as a diagnostic tool of the first choice for primary screening of CI in this cohort of patients.


KEYWORDS: psychometrics, neuropsychological examination, MMSE, МоСА, ischemic stroke, cognitive functions, cognitive impairment

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation:

Котельникова А.В., Погонченкова И.В., Костенко Е.В., Петрова Л.В., Хаустова А.В. Психометрическая апробация скрининговых методик диагностики когнитивного статуса постинсультных пациентов: обсервационное когортное исследование. Вестник восстановительной медицины. 2023; 22(2):32-41. https://doi.org/10.38025/2078-1962-2023-22-2-32-41. [Kotelnikova A.V., Pogonchenkova I.V., Kostenko E.V., Petrova L.V., Khaustova A.V. Psychometric Approbation of Screening Methods for the Diagnosis of Cognitive Status in a Sample of Ischemic Stroke Patients: an Observational Cohort Study. Bulletin of Rehabilitation Medicine. 2023; 22(2): 32-41. https://doi.org/10.38025/2078-1962-2023-22-2-32-41 (In Russ.).

For correspondence:

 Anastasia V. Kotelnikova, E-mail: pav-kotelnikov@yandex.ru; nauka-org@mail.ru; ORCID: https://orcid.org/0000-0002-9605-557X



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