Diagnostic accuracy of the Clock Drawing Test in screening for early post-stroke neurocognitive disorder: the Nor-COAST study

Post-stroke neurocognitive disorder, though common, is often overlooked by clinicians. Moreover, although the Montreal Cognitive Assessment (MoCA) has proven to be a valid screening test for neurocognitive disorder, even more time saving tests would be preferred. In our study, we aimed to determine...

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Bibliographic Details
Published in:BMC neurology 2024-01, Vol.24 (1), p.22-22, Article 22
Main Authors: Navickaite, Egle, Saltvedt, Ingvild, Lydersen, Stian, Munthe-Kaas, Ragnhild, Ihle-Hansen, Hege, Grambaite, Ramune, Aam, Stina
Format: Article
Language:English
Subjects:
Accuracy
Activities of daily living
Aged
Analysis
Care and treatment
Clock Drawing Test
Cognition
Cognition & reasoning
Cognitive ability
Dementia
Diagnosis
Executive function
Female
Humans
Life expectancy
Male
Medical research
Medical screening
Medical tests
Medicine, Experimental
Mental disorders
Mental illness
Mental Status and Dementia Tests
Neurocognitive Disorders
Neurologic Examination
Post-stroke cognitive impairment
Post-stroke neurocognitive disorder
Prospective Studies
Risk factors
Screening
Stroke
Stroke - complications
Stroke - diagnosis
Stroke patients
United States
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Summary:Post-stroke neurocognitive disorder, though common, is often overlooked by clinicians. Moreover, although the Montreal Cognitive Assessment (MoCA) has proven to be a valid screening test for neurocognitive disorder, even more time saving tests would be preferred. In our study, we aimed to determine the diagnostic accuracy of the Clock Drawing Test (CDT) for post-stroke neurocognitive disorder and the association between the CDT and MoCA. This study is part of the Norwegian Cognitive Impairment After Stroke study, a multicentre prospective cohort study following patients admitted with acute stroke. At the three-month follow-up, patients were classified with normal cognition, mild neurocognitive disorder, or major neurocognitive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Any neurocognitive disorder compromised both mild- and major neurocognitive disorder. The CDT at the three-month assessment was given scores ranging from 0 to 5. Patients able to complete the CDT and whose cognitive status could be classified were included in analyses. The CDT diagnostic accuracy for post-stroke neurocognitive disorder was identified using receiver operating characteristic curves, sensitivity, specificity, positive predictive value, and negative predictive value. The association between the MoCA and CDT was analysed with Spearman's rho. Of 554 participants, 238 (43.0%) were women. Mean (SD) age was 71.5 (11.8) years, while mean (SD) National Institutes of Health Stroke Scale score was 2.6 (3.7). The area under the receiver operating characteristic curve of the CDT for major neurocognitive disorder and any neurocognitive disorder was 0.73 (95% CI, 0.68-0.79) and 0.68 (95% CI, 0.63-0.72), respectively. A CDT cutoff of 
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-023-03523-w