Addenbrooke’s Cognitive Examination in Nondemented Patients after Stroke

Abstract

Introduction:Cognitive deficit after stroke is common, and beginning cognitive rehabilitation as soon as possible is important to minimize the consequences of the impairment. The aim of this study was to use Addenbrooke's Cognitive Examination to compare cognitive function in nondemented and nondepressed stroke patients, 3-6 months after the stroke, with sex-and age-matched controls. Materials and Methods:A total of 156 participants were included (72 controls: 19 men, mean age 64.5 ± 12.4 years; 84 patients after stroke: 54 men, mean age 62.2 ± 9.0 years).Results: Statistically significant differences were identified between controls and stroke patients in total Addenbrooke's score (stroke patients, 86.2 points vs controls, 91.2 points; p<0.01), Verbal Production domain (stroke patients, 9.8 points vs controls, 11.5 points; p<0.01), and Memory domain (stroke patients, 19.5 points vs controls, 21.7 points; p<0.01). The difference was also statistically significant between subgroups of stroke patients and controls: patients with a right-sided brain lesion differed from controls in total scores (88.3 vs 91.3 points, respectively; p<0.05) and Verbal Production domain scores (9.9 vs 11.5 points, p<0.01), as did patients with left-sided brain lesions in total score (83.9 vs 91.3 points; p<0.01) and Memory (18.6 vs 21.7 points; p<0.01) and Verbal Production (9.6 vs 11.5 points; p<0.01) domains. Conclusion:This study shows the usability of Addenbrooke's Cognitive Examination 3-6 months after a stroke to detect mild cognitive decline, providing a basis for initiating cognitive rehabilitation as soon as possible.

Influence of New Technologies on Post-Stroke Rehabilitation: A Comparison of Armeo Spring to the Kinect System

“…The main outcome measures used for evaluation of UL recovery after stroke were the following: the Fugl–Meyer Assessment Upper Extremity (FMA-UE, 0 = lowest score; 66 = highest score) [8,13,17]; the shoulder, elbow, and wrist flexion tones were assessed by using the Modified Ashworth Scale (MAS, range 0–4 points) [8]; the gross manual dexterity were assessed by Box and Block Test (BBT, count of cubes during 60 s) [8]; the Hand Tapping Score Test (HTS, score(s) of 25 arm movements) [14]; and to obtain kinematic parameters of requested movements, active Range Of Motion (ROM) of the shoulder, elbow, and wrist was measured [9], and the affected hand grip strength was measured with a hand-grip dynamometer (average of grip strength in kg). The Modified Functional Independence Measure (FIM, 6-item self-care, max 42 point) [15] was used for evaluation of the degree of independence and assistance needed in activities of daily living; to measure cognitive impairment, the Mini-Mental State Examination (MMSE, range 21 ≥ 30 point) [16] and Addenbrooke’s Cognitive Examination-Revised (ACE-R, max 100 points; a higher score reflects a better outcome) were used [18], and the psycho-emotional state was assessed by the Hospital Anxiety and Depression Scale (HAD, range 0–21 points; a higher score reflects higher anxiety and depression level) [19]. The following assessments were extracted at the beginning (pre-outcomes) and at the end (post-outcomes) of the therapy.…”

Degree of cognitive impairment in patients with carotid stenosis in relation to cerebral ischemic lesions

“…The limitation of our study is that CT and MRI scans were not done simultaneously, and the time between the symptom onset and MRI scans was longer compared to the timing of CT scans. As early ischemic changes become more prominent in time, this fact goes potentially in favor of the MRI often have a language difficulty 15,16 . In our study, there was no statistically significant correlation between the lesion location at admission and control CT scans, MRI scans in the examined groups of patients compared to the level of cognitive impairment seen on the ACE-R test.…”

“…In our study, there was no statistically significant correlation between the lesion location at admission and control CT scans, MRI scans in the examined groups of patients compared to the level of cognitive impairment seen on the ACE-R test. In our study, we have chosen neuropsychological testing which is necessary for the screening of patients with dementia after stroke or patients with carotid stenosis, without the anamnestic data for stroke and its identification in the early stages of the disease, which would enable early intervention and possible delay of the cognitive impairment development with proper cognitive rehabilitation 15 15,16 . The speech and verbal fluency, which were tested with ACE-R, were in correlation with tests that assess attention and executive functions (the trail making test, memory span, Stroop test) 16 .…”

“…The study ofLees et al, studied the usefulness of ACE-R test in detecting cognitive impairment after a stroke16 . The test gives data for the patient's cognitive profile and as a screening method can speed up the cognitive deficit diagnostic process after stroke15 . It was shown that the ACE -R has a significant connection with other neuropsychological teststhat examine only a certain domain.…”

<p>Addenbrooke&#39;s cognitive examination III in the diagnosis of dementia: a critical review</p>

“…In this way, it provides the clinician with useful information about the cognitive functions of the patient. Moreover, the application of a screening tool can accelerate the diagnostic process of cognitive deficit after stroke and implementing cognitive rehabilitation 32…”