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Journal article

Validation of the UK English Oxford cognitive screen-plus in sub-acute and chronic stroke survivors

Abstract:

Introduction: Stroke survivors are routinely screened for cognitive impairment with tools that often fail to detect subtle impairments. The Oxford Cognitive Screen-Plus (OCS-Plus) is a brief tablet-based screen designed to detect subtle post-stroke cognitive impairments. We examined its psychometric properties in two UK English-speaking stroke cohorts (subacute: <3 months post-stroke, chronic: >6 months post-stroke) cross-sectionally.

Patients and methods: This study included 347 stroke survivors (mean age = 73 years; mean education = 13 years; 43.06% female; 74.42% ischaemic stroke). The OCS-Plus was completed by 181 sub-acute stroke survivors and 166 chronic stroke survivors. All participants also completed the Oxford Cognitive Screen (OCS) and a subset completed the Montreal Cognitive Assessment (MoCA) and further neuropsychological tests.

Results: First, convergent construct validity of OCS-Plus tasks to task-matched standardized neuropsychological tests was confirmed (r > 0.30). Second, we evaluated divergent construct validity of all OCS-Plus subtasks (r < 0.19). Third, we report the sensitivity and specificity of each OCS-Plus subtask compared to neuropsychological test performance. Fourth, we found that OCS-Plus detected cognitive impairments in a large proportion of those classed as unimpaired on MoCA (100%) and OCS (98.50%).

Discussion and conclusion: The OCS-Plus provides a valid screening tool for sensitive detection of subtle cognitive impairment in stroke patients. Indeed, the OCS-Plus detected subtle cognitive impairment at a similar level to validated neuropsychological assessments and exceeded detection of cognitive impairment compared to standard clinical screening tools.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1177/23969873221119940

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
Experimental Psychology
Oxford college:
Kellogg College
Role:
Author
ORCID:
0000-0002-0029-4665


Publisher:
SAGE Publications
Journal:
European Stroke Journal More from this journal
Volume:
7
Issue:
4
Pages:
476 - 486
Publication date:
2022-08-19
Acceptance date:
2022-07-22
DOI:
EISSN:
2396-9881
ISSN:
2396-9873


Language:
English
Keywords:
Pubs id:
1277461
Local pid:
pubs:1277461
Deposit date:
2022-10-03

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