title: Test Accuracy of Informant-Based Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke.
abstract: OBJECTIVE
  Poststroke cognitive assessment can be performed using standardized questionnaires designed for family or care givers. We sought to describe the test accuracy of such informant-based assessments for diagnosis of dementia/multidomain cognitive impairment in stroke.
  
  
  METHODS
  We performed a systematic review using a sensitive search strategy across multidisciplinary electronic databases. We created summary test accuracy metrics and described reporting and quality using STARDdem and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools, respectively.
  
  
  RESULTS
  From 1432 titles, we included 11 studies. Ten papers used the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Four studies described IQCODE for diagnosis of poststroke dementia (n=1197); summary sensitivity: 0.81 (95% confidence interval, 0.60-0.93); summary specificty: 0.83 (95% confidence interval, 0.64-0.93). Five studies described IQCODE as tool for predicting future dementia (n=837); summary sensitivity: 0.60 (95% confidence interval, 0.32-0.83); summary specificity: 0.97 (95% confidence interval, 0.70-1.00). All papers had issues with at least 1 aspect of study reporting or quality.
  
  
  CONCLUSIONS
  There is a limited literature on informant cognitive assessments in stroke. IQCODE as a diagnostic tool has test properties similar to other screening tools, IQCODE as a prognostic tool is specific but insensitive. We found no papers describing test accuracy of informant tests for diagnosis of prestroke cognitive decline, few papers on poststroke dementia and all included papers had issues with potential bias.
authors.affiliation: From the Department of Academic Geriatric Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (A.M.G.); Oxford and Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (S.T.P.); Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (N.K.M., T.J.Q.); and Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China (Y.F.).
authors.forename: Aine
authors.initials: A
authors.lastname: McGovern
authors.affiliation: From the Department of Academic Geriatric Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (A.M.G.); Oxford and Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (S.T.P.); Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (N.K.M., T.J.Q.); and Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China (Y.F.).
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Pendlebury
authors.affiliation: From the Department of Academic Geriatric Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (A.M.G.); Oxford and Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (S.T.P.); Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (N.K.M., T.J.Q.); and Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China (Y.F.).
authors.forename: Nishant K
authors.initials: NK
authors.lastname: Mishra
authors.affiliation: From the Department of Academic Geriatric Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (A.M.G.); Oxford and Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (S.T.P.); Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (N.K.M., T.J.Q.); and Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China (Y.F.).
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Fan
authors.affiliation: From the Department of Academic Geriatric Medicine, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (A.M.G.); Oxford and Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (S.T.P.); Department of Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (N.K.M., T.J.Q.); and Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China (Y.F.).
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Quinn
mesh_terms: D017028:Caregivers; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D003704:Dementia / Q000150:complications / Q000175:diagnosis*; D005190:Family; D006801:Humans; D008403:Mass Screening; D019727:Proxy; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: cognition; dementia; sensitivity; specificity; stroke