Telephone Assessment of Cognition After Transient Ischemic Attack and Stroke

Sarah T. Pendlebury; Sarah J.V. Welch; Fiona C. Cuthbertson; José Mariz; Ziyah Mehta; Peter M. Rothwell

doi:10.1161/strokeaha.112.673384

journal article Jan 01, 2013

Telephone Assessment of Cognition After Transient Ischemic Attack and Stroke

Sarah T. Pendlebury Sarah J.V. Welch Fiona C. Cuthbertson José Mariz Ziyah Mehta Peter M. Rothwell

Stroke Vol. 44 No. 1 pp. 227-229 · Ovid Technologies (Wolters Kluwer Health)

View at Publisher Save 10.1161/strokeaha.112.673384

Abstract

Background and Purpose—
Face-to-face cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face cognitive tests in patients with transient ischemic attack (TIA) or stroke.

Methods—
In a population-based study, consecutive community-dwelling patients underwent the MoCA and neuropsychological battery >1 year after TIA or stroke, followed by T-MoCA (22 points) and TICSm (39 points) at least 1 month later. Mild cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the receiver-operating characteristic curve (AUC) determined for T-MoCA and TICSm.

Results—

Ninety-one nondemented subjects completed neuropsychological testing (mean±SD age, 72.9±11.6 years; 54 males; stroke 49%) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction, and verbal fluency were significantly worse (
P
<0.02) by telephone than during face-to-face testing. Reliability of diagnosis for MCI (AUC) were T-MoCA of 0.75 (95% confidence interval [CI], 0.63–0.87) and TICSm of 0.79 (95% CI, 0.68–0.90) vs face-to-face MoCA of 0.85 (95% CI, 0.76–0.94). Optimal cutoffs were 18 to 19 for T-MoCA and 24 to 25 for TICSm. Reliability of diagnosis for MCI (AUC) was greater when only multi-domain impairment was considered (T-MoCA=0.85; 95% CI, 0.75–0.96 and TICSm=0.83, 95% CI, 0.70–0.96) vs face-to-face MoCA=0.87; 95% CI, 0.76–0.97).

Conclusions—
Both T-MoCA and TICSm are feasible and valid telephone tests of cognition after TIA and stroke but perform better in detecting multi-domain vs single-domain impairment. However, T-MoCA is limited in its ability to assess visuoexecutive and complex language tasks compared with face-to-face MoCA.

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Metrics

332

Citations

12

References

Details

Published: Jan 01, 2013
Vol/Issue: 44(1)
Pages: 227-229

Authors

S

Sarah T. Pendlebury

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

S

Sarah J.V. Welch

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

F

Fiona C. Cuthbertson

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

J

José Mariz

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

Z

Ziyah Mehta

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

P

Peter M. Rothwell

From the Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK, and the University of Oxford, Oxford, UK (S.T.P., S.J.V.W, F.C.C., J.M., Z.M., P.M.R.); and National Institute of Health Research Biomedical Research Centre, Oxford, UK (S.T.P.).

Cite This Article

Sarah T. Pendlebury, Sarah J.V. Welch, Fiona C. Cuthbertson, et al. (2013). Telephone Assessment of Cognition After Transient Ischemic Attack and Stroke. Stroke, 44(1), 227-229. https://doi.org/10.1161/strokeaha.112.673384

Telephone Assessment of Cognition After Transient Ischemic Attack and Stroke

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