Cameron, J. D, Gallagher, R., Pressler, S. J, McLennan, S. N, Ski, C. F, Tofler, G. H & Thompson, DR. (2016). Sensitivity and specificity of a five-minute cognitive screening test in patients with heart failure. Journal of Cardiac Failure,22(2), 99-107. United States: Churchill Livingstone. Retrieved from https://doi.org/10.1016/j.cardfail.2015.08.343
Background: Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients. Methods: The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen. Results: In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA < 26). Scores on the NINDS-CSN screen ranged from 3–11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88; P < .01; 95% CI 0.83–0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity. Conclusions: The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols.
Mary MacKillop Institute for Health Research
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