Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery.
Telephone assessment of cognition after transient ischemic attack and stroke: modified telephone interview of cognitive status and telephone Montreal Cognitive Assessment versus face-to-face Montreal Cognitive Assessment and neuropsychological battery.
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DOI：
10.1161/strokeaha.112.673384
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发表时间：
2013-01
期刊：
影响因子：
8.3
通讯作者：
Rothwell PM
中科院分区：
文献类型：
--
作者：
Pendlebury ST;Welch SJ;Cuthbertson FC;Mariz J;Mehta Z;Rothwell PM
在大型研究中，面对面的认知测试并不总是可行的。因此，我们评估了电话蒙特利尔认知评估（T-MoCA: MoCA项目不需要铅笔和纸和/或视觉刺激）和改进的认知状态电话访谈（TICSm）与面对面认知测试在TIA或中风患者中的对比。在一项以人群为基础的研究中，连续社区居住的患者在TIA或中风后至少1年进行MoCA和神经心理电池测试，然后在至少一个月后进行T-MoCA（22分）和TICSm（39分）。采用改良的Petersen标准诊断轻度认知障碍（MCI），并测定T-MoCA和TICSm的ROC曲线下面积（AUC）。91例无痴呆的受试者完成了神经心理测试（平均±sd年龄72.9±11.6岁，男性54例，中风49例），73例进行了电话随访。与面对面测试相比，电话测试在重复、抽象和语言流畅性方面的MoCA子测试得分显著降低（p<0.02）。MCI诊断的可靠性（AUC）为：T-MoCA=0.75, 95% CI 0.63-0.87, TICSm=0.79,0.68-0.90，面对面MoCA=0.85, 0.76-0.94。T-MoCA的最佳截止时间为18/19，TICSm的最佳截止时间为24/25。仅考虑多域损伤时，诊断MCI （AUC）的可靠性更高：T-MoCA=0.85,0.75-0.96；TICSm=0.83,0.70-0.96，面对面MoCA=0.87,0.76-0.97。T-MoCA和TICSm都是TIA和脑卒中后认知的电话测试，但在检测多域与单域损伤方面表现更好。然而，与面对面的MoCA相比，T-MoCA在评估视觉执行和复杂语言任务方面的能力有限。
Face-to-face cognitive testing is not always possible in large studies. We therefore assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper and/or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face cognitive tests in patients with TIA or stroke. In a population-based study, consecutive community dwelling patients had the MoCA and neuropsychological battery ≥1 year after TIA or stroke followed by T-MoCA (22-points) and TICSm (39-points) at least one month later. Mild cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the ROC curve (AUC) determined for T-MoCA and TICSm. 91 non-demented subjects completed neuropsychological testing (mean±sd age 72.9±11.6 years, 54 male, 49 stroke) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction and verbal fluency were significantly worse (p<0.02) by phone than at face-to-face testing. Reliability of diagnosis for MCI (AUC) was: T-MoCA=0.75, 95% CI 0.63-0.87, TICSm=0.79,0.68-0.90 vs face-to-face MoCA=0.85, 0.76-0.94. Optimal cut-offs were 18/19 on T-MoCA and 24/25 on TICSm. Reliability of diagnosis for MCI (AUC) was greater when only multi-domain impairment was considered: T-MoCA=0.85,0.75-0.96; TICSm=0.83,0.70-0.96 vs face-to-face MoCA=0.87,0.76-0.97. Both T-MoCA and TICSm are feasible and valid telephone tests of cognition after TIA and stroke but perform better in detecting multi- vs single-domain impairment. However, T-MoCA is limited in its ability to assess visuoexecutive and complex language tasks compared to face-to-face MoCA.