Feasibility of cognitive screening of patients with ischaemic stroke using the CAMCOG A hospital-based study

Kwa, Vincent I H; Limburg, M.; Voogel, A. J.; Teunisse, S.; Derix, M.M.A.; Hijdra, A.

doi:10.1007/bf00869000

Cited by 25 publications

(19 citation statements)

References 13 publications

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“…The experience with the CAMCOG in stroke populations is limited. Kwa et al 33 found that the CAMCOG was administrable in 88% of an ischemic stroke population, which also included patients younger than 55 years. Since their main interest was in the extent to which the CAMCOG is feasible in an ischemic stroke population, they included all aphasic patients and allowed adaptations in administration, such as the use of gestures.…”

Section: Discussionmentioning

confidence: 99%

The CAMCOG: A Useful Screening Instrument for Dementia in Stroke Patients

Koning

Kooten

Dippel³

et al. 1998

Stroke

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Background and Purpose-Most mental screening tests focus on the detection of cognitive deficits compatible with Alzheimer's disease. Stroke patients who develop a dementia syndrome, however, constitute a more heterogeneous group with both cortical and subcortical disturbances. We assessed the diagnostic accuracy of the CAMCOG (the cognitive and self-contained part of the Cambridge Examination for Mental Disorders of the Elderly) and the Mini-Mental State Examination (MMSE) for dementia in patients with a recent stroke. Methods-In patients aged 55 and older who were admitted in the Rotterdam Stroke Databank, cognitive functioning was assessed between 3 and 9 months after the most recent stroke. The "gold standard" diagnosis of dementia was compatible with the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. The CAMCOG and MMSE scores were obtained independent of the diagnostic procedure. Results-Of 300 consecutive patients, 71 (23.7%) were demented. Sixteen severely demented patients could not be tested and were excluded. The CAMCOG and MMSE scores were significantly related to dementia (both PϽ0.0001) in a logistic regression model. Receiver operating characteristic analysis showed that the CAMCOG was a more accurate screening instrument (area under the curve for CAMCOG, 0.95; for MMSE, 0.90). Two other clinical variables independently improved the diagnostic accuracy of the MMSE and CAMCOG: patients with a left hemispheric lesion had a lower (odds ratio, 0.3; 95% confidence interval, 0.1 to 0.7), and patients with hemorrhagic stroke had a greater chance of being demented (odds ratio, 3; 95% confidence interval, 1 to 10). The effect of left hemispheric lesion as an independent diagnostic factor could not be explained by selection or its association with aphasia alone. Conclusions-The CAMCOG is a feasible instrument for use in patients with a recent transient ischemic attack or stroke.It is a more accurate screening tool for dementia than the MMSE, especially when type and site of stroke are taken into account. (Stroke. 1998;29:2080-2086.)

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Section: Discussionmentioning

confidence: 99%

The CAMCOG: A Useful Screening Instrument for Dementia in Stroke Patients

Koning

Kooten

Dippel³

et al. 1998

Stroke

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“…The mean score on the MMSE was 24.3 6 3.7 (range, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. More specifically, impairment in short-term memory was noted in 148 patients (78.7%); in orientation to time, in 100 patients (53.2%); in visuospatial construction, in 77 patients (42.8%); in attention, in 89 patients (47.3%); and in expressive language, in 79 patients (42.5%).…”

Section: Description Of Cognitive Impairmentsmentioning

confidence: 99%

Cognitive Functioning in the Acute Phase Poststroke: A Predictor of Discharge Destination?

Zwaluw

Valentijn

Mark

et al. 2011

Journal of Stroke and Cerebrovascular Diseases

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“…Considering the structure of these tests and the administration time, however, these tests are in fact microbatteries and, in our opinion, do not serve the purpose of a dementia screening instrument Previously, we found that the CAMCOG is a feasible screening instrument in a stroke population, 8 which confirmed an earlier study. 7 Nevertheless, the CAMCOG still has drawbacks when applied in patients with a recent stroke. The CAMCOG contains items that seem inassessable in some stroke patients due to upper extremity paresis or aphasia; this will lead to missing values.…”

Section: Table 2 Distribution Of the Items And Subscales In The Camcmentioning

confidence: 99%

“…Previous studies have nevertheless shown that the CAMCOG is a feasible test for dementia in a stroke population. 7,8 We studied its utility as a screening instrument for dementia in a stroke population and found that the CAMCOG was more accurate than the Mini-Mental State Examination (MMSE). The diagnostic accuracy of the CAMCOG could even be improved when type and site of stroke were taken into account.…”

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confidence: 99%

A Short Screening Instrument for Poststroke Dementia

Koning

Dippel

Kooten

et al. 2000

Stroke

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Background and Purpose-The CAMCOG is a feasible cognitive screening instrument for dementia in patients with a recent stroke. A major disadvantage of the CAMCOG, however, is its lengthy and relatively complex administration for screening purposes. We therefore developed the Rotterdam CAMCOG (R-CAMCOG), based on the original version.Our aim was to reduce the estimated administration time to 15 minutes or less and to retain or perhaps even improve its diagnostic accuracy. Methods-We analyzed the item scores on the CAMCOG of 300 consecutive stroke patients, after exclusion of patients with a severe aphasia or lowered consciousness level, who were entered in the Rotterdam Stroke Databank. The diagnosis of dementia was made independent of the R-CAMCOG score, on the basis of clinical examination and neuropsychological test results. The R-CAMCOG was constructed in 3 steps. First, items with floor and ceiling effects were removed. Next, subscales with no additional diagnostic value were excluded. Finally, we removed items that did not contribute to the homogeneity of the subscales. The diagnostic accuracy of the R-CAMCOG and the original CAMCOG was determined by means of the area under the receiver operating characteristic (ROC) curve. Results-In the 3 steps, the number of items was reduced from 59 to 25, divided over the subscales orientation, memory (recent, remote, and learning), perception, and abstraction. The subscale orientation did not reach significance in a logistic regression model but was included in the R-CAMCOG because of its high face validity in dementia screening.Internal validation with ROC analysis suggests that the R-CAMCOG and the CAMCOG are equally accurate in screening for poststroke dementia (area under the curve was 0.95 for both tests). Conclusions-The R-CAMCOG has overcome the disadvantages of the original CAMCOG. It is a promising, short, and easy-to-administer screening instrument for poststroke dementia. It seems to be sufficiently accurate for this purpose, but the test has yet to be validated in a separate, independent study. (Stroke. 2000;31:1502-1508.)

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Feasibility of cognitive screening of patients with ischaemic stroke using the CAMCOG A hospital-based study

Cited by 25 publications

References 13 publications

The CAMCOG: A Useful Screening Instrument for Dementia in Stroke Patients

The CAMCOG: A Useful Screening Instrument for Dementia in Stroke Patients

Cognitive Functioning in the Acute Phase Poststroke: A Predictor of Discharge Destination?

A Short Screening Instrument for Poststroke Dementia

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