Impact of different methods defining post-stroke neurocognitive disorder: The Nor-COAST study

Alzheimers Dement (N Y). 2020 Mar 16;6(1):e12000. doi: 10.1002/trc2.12000. eCollection 2020.


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.

Keywords: classification; cognition; cognitive impairment; dementia; stroke.