Impact of different methods defining post-stroke neurocognitive disorder: The Nor-COAST study
Munthe-Kaas R., Aam S., Ihle-Hansen H., Lydersen S., Knapskog AB., Wyller TB., Fure B., Thingstad P., Askim T., Beyer MK., Næss H., Seljeseth YM., Ellekjær H., Pendlebury ST., Saltvedt I.
© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association. Introduction: Post-stroke neurocognitive disorder (NCD) is common; prevalence varies between studies, partially related to lack of consensus on how to identify cases. The aim was to compare the prevalence of post-stroke NCD using only cognitive assessment (model A), DSM-5 criteria (model B), and the Global Deterioration Scale (model C) and to determine agreement among the three models. Methods: In the Norwegian Cognitive Impairment After Stroke study, 599 patients were assessed 3 months after suffering a stroke. Results: The prevalence of mild NCD varied from 174 (29%) in model B to 83 (14%) in model C; prevalence of major NCD varied from 249 (42%) in model A to 68 (11%) in model C. Cohen's kappa and Cohen's quadratic weighted kappa showed fair to very good agreement among models; the poorest agreement was found for identification of mild NCD. Discussion: The findings indicate a need for international harmonization to classify post-stroke NCD.