A Systematic Review of the Definitions of Vascular Cognitive Impairment, No Dementia in Cohort Studies

Harrison, Stephanie L; Tang, Eugene; Keage, Hannah A.D.; Allan, Louise; Robinson, Louise; Jagger, Carol; Rockwood, Kenneth; Stephan, Blossom C. M.

doi:10.1159/000448213

Cited by 23 publications

(18 citation statements)

References 44 publications

(159 reference statements)

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“…managing money). 3 This is consistent with the recent DSM-5 criteria which emphasise impairment in IADLs as a distinguishing factor between major and minor neurocognitive disorder. These new criteria also do not require memory impairment, which is not always present in stroke-related dementia.…”

Section: Introductionsupporting

confidence: 89%

“…Studies vary as to the number of domains that must be impaired, the number of tests per domain, how domains are defined, and specific cut-offs used to define impairment. 3,4 Early definitions focussed on the concept of mild cognitive impairment (MCI), primarily framed as a pre-cursor to Alzheimer's disease. 5 This definition often requires intact basic activities of daily living (ADLs), which can be problematic for stroke patients who may have ADL difficulties due to sensorimotor problems, independent of cognitive function.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Sexton

McLoughlin

Williams

et al. 2019

European Stroke Journal

142

105

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Introduction: Increasing attention is being paid to interventions for cognitive impairment (CI) post-stroke, including for CI that does not meet dementia criteria. The aim of this paper was to conduct a systematic review and meta-analysis of the prevalence of cognitive impairment no dementia (CIND) within one year post-stroke. Patients and methods: Pubmed, EMBASE and PsychInfo were searched for papers published in English in 1995-2017. Included studies were population or hospital-based cohort studies for first-ever/recurrent stroke, assessing CIND using standardised criteria at 1-12 months post-stroke. Abstracts were screened, followed by full text review of potentially relevant articles. Data were extracted using a standard form, and study quality was appraised using the Crowe Critical Appraisal Tool. A pooled prevalence of CIND with 95% confidence intervals (CI) was estimated using random-effects meta-analysis. Heterogeneity was measured using the I 2 statistic. Results: A total of 7000 abstracts were screened, followed by 1028 full text articles. Twenty-three articles were included in the systematic review, and 21 in the meta-analysis. The pooled CIND prevalence was 38% [95% CI ¼ 32-43%] (I 2 ¼92.5%, p < 0.01). Study quality emerged as one source of heterogeneity. The five studies with the highest quality scores had no heterogeneity (I 2 ¼0%, p ¼ 0.99), with a similar pooled prevalence (39%, 95%CI ¼ 35-42%). Other sources of heterogeneity were stroke type, inclusion of pre-stroke CI, and age at assessment time. Discussion and conclusion: Meta-analysis of available studies indicates that in the first year post-stroke, 4 in 10 patients display a level of cognitive impairment that does not meet the criteria for dementia.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Sexton

McLoughlin

Williams

et al. 2019

European Stroke Journal

142

105

View full text Add to dashboard Cite

show abstract

“…This supports the hypothesis that, within a given patient population, there will be greater variation between methods used to define mild NCD than in those defining major NCD, in line with the findings of systematic reviews on post-stroke NCD 14,15 and studies of mild NCD methodology. 1,6,44 Most participants classified with major NCD by the GDS were also classified with major NCD in models A and B, indicating a high specificity of this method. The discrepancy for mild and major NCD between models A and B highlights a problem with applying the DSM-5 criteria, as the criteria have requirements for both neuropsychological performance and for I-ADL to decide on the severity of NCD.…”

Section: Discussionmentioning

confidence: 94%

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

Munthe-Kaas

Aam

Ihle‐Hansen

et al. 2020

A&D Transl Res & Clin Interv

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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.

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“…Vascular Cognitive Impairment no Dementia (VCI-ND) sits within the spectrum of VCI and is defined as a pre-dementia state associated with increased future risk of cognitive decline and dementia. Although this may be found to be useful for identifying those at greatest risk of future dementia, no single set of criteria for defining VCI-ND yet exist and the predictive accuracy of the state has not been investigated in detail in stroke patients [37].…”

Section: Risk Prediction Models For Cognitive Decline and Dementiamentioning

confidence: 99%

Risk Prediction Models for Post-Stroke Dementia

2017

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A strong association exists between stroke and dementia with both diseases linked to ageing. Survival rates from stroke are improving which would equate to an ever-expanding population of patients at risk of future dementia. Early or timelier identification of dementia has become a priority in many countries, including the UK. Although screening for dementia is not advocated, targeting at risk populations could be used to reduce an individual's risk via intervention (i.e., personalised medicine), where available. One approach to improving identification of high-risk dementia individuals is using risk prediction models. Such models could be applied to stroke survivors. Dementia risk prediction models specific to stroke survivors have recently been developed and will be discussed here.

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A Systematic Review of the Definitions of Vascular Cognitive Impairment, No Dementia in Cohort Studies

Cited by 23 publications

References 44 publications

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

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

Risk Prediction Models for Post-Stroke Dementia

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