title: Prediction of post-stroke dementia using NINDS-CSN 5-minute neuropsychology protocol in acute stroke.
abstract: The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.
  
  
  
  We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.
  
  
  
  Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65-15.05).
  
  
  
  The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Jae-Sung
authors.identifier: 0000-0001-6157-2908
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Oh
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Ju-Hun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: San
authors.initials: S
authors.lastname: Jung
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Chulho
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Min Uk
authors.initials: MU
authors.lastname: Jang
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Sang-Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Yeo Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Yerim
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Jaeseol
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Psychology,Hallym University College of Social Sciences,Chuncheon,Republic of Korea.
authors.forename: Yeonwook
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.affiliation: Department of Neurology,Hallym Neurological Institute,Hallym University College of Medicine,Anyang,Republic of Korea.
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
mesh_terms: D000368:Aged; D003071:Cognition; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055825:National Institute of Neurological Disorders and Stroke (U.S.); D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D014481:United States
keywords: cerebral infarction; montreal cognitive assessment; post-stroke dementia; vascular cognitive impairment