AUTHOR=Xu Yangfan , Yi Lingrong , Lin Yangyang , Peng Suiying , Wang Weiming , Lin Wujian , Chen Peize , Zhang Weichao , Deng Yujie , Guo Suimin , Shi Le , Wang Yuling , Molloy D. William , O'Caoimh Rónán 

TITLE=Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.608188

DOI=10.3389/fneur.2021.608188

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Screening for post-stroke cognitive impairment (PSCI) is necessary because stroke increases the incidence of and accelerates premorbid cognitive decline. The Quick Mild Cognitive Impairment (Q<italic>mci</italic>) screen is a short, reliable and accurate cognitive screening instrument but is not yet validated in PSCI. We compared the diagnostic accuracy of a Chinese version of the Q<italic>mci</italic> screen (Q<italic>mci</italic>-CN) compared with the widely-used Chinese versions of the Montreal Cognitive Assessment (MoCA-CN) and Mini-Mental State Examination (MMSE-CN).</p><p><bold>Methods:</bold> We recruited 34 patients who had recovered from a stroke in rehabilitation unit clinics in 2 university hospitals in China: 11 with post-stroke dementia (PSD), 15 with post-stroke cognitive impairment no dementia (PSCIND), and 8 with normal cognition (NC). Classification was made based on clinician assessment supported by a neuropsychological battery, independent of the screening test scores. The Q<italic>mci</italic>-CN, MoCA-CN, and MMSE-CN screens were administered randomly by a trained rater, blind to the diagnosis.</p><p><bold>Results:</bold> The mean age of the sample was 63 ± 13 years and 61.8% were male. The Q<italic>mci</italic>-CN had statistically similar diagnostic accuracy in differentiating PSD from NC, an area under the curve (AUC) of 0.94 compared to 0.99 for the MoCA-CN (<italic>p</italic> = 0.237) and 0.99 for the MMSE-CN (<italic>p</italic> = 0.293). The Q<italic>mci</italic>-CN (AUC 0.91), MoCA-CN (AUC 0.94), and MMSE-CN (AUC 0.79) also had statistically similar accuracy in separating PSD from PSCIND. The MoCA-CN more accurately distinguished between PSCIND and normal cognition than the Q<italic>mci</italic>-CN (<italic>p</italic> = 0.015). Compared to the MoCA-CN, the administration times of the Q<italic>mci</italic>-CN (329s vs. 611s, respectively, <italic>p</italic> &lt; 0.0001) and MMSE-CN (280 vs. 611s, respectively, <italic>p</italic> &lt; 0.0001) were significantly shorter.</p><p><bold>Conclusion:</bold> The Q<italic>mci</italic>-CN is accurate in identifying PSD and separating PSD from PSCIND in patients post-stroke following rehabilitation and is comparable to the widely-used MoCA-CN, albeit with a significantly shorter administration time. The Q<italic>mci</italic>-CN had relatively poor accuracy in identifying PSCIND from NC and hence may lack accuracy for certain subgroups. However, given the small sample size, the study is under-powered to show superiority of one instrument over another. Further study is needed to confirm these findings in a larger sample size and in other settings (countries and languages).</p>