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Sanctuary C, Hewitt L, Demeyere N, Kankkunen K, Oxenham DV, Simpson DB, Stolwyk RJ, Synn A, Webb SS, Marsden DL. The Oxford Cognitive Screen for use with Australian people after stroke (OCS-AU): The adaptation process and determining cut scores for cognitive impairment using a cross-sectional normative study. Aust Occup Ther J 2023; 70:73-85. [PMID: 36047309 PMCID: PMC10087605 DOI: 10.1111/1440-1630.12838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/20/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Two parallel versions (A and B) of the Oxford Cognitive Screen (OCS) were developed in the United Kingdom (UK) as a stroke-specific screen of five key cognitive domains commonly affected post-stroke. We aimed to develop the Australian versions A and B (OCS-AU), including Australian cut-scores indicative of impairment. We hypothesised there to be no difference in performance between the UK and Australian normative data cohorts. METHODS Our multidisciplinary expert panel used the UK pre-defined process to develop the OCS-AU versions A and B. We then conducted a cross-sectional normative study. We purposively recruited community-dwelling, Australian-born, and educated adults; with no known cognitive impairment; representative of age, sex, education level, and living location; at seven sites (four metropolitan, three regional) across four Australian states. Participants completed one or both OCS-AU versions in a randomised order. Australian cohorts were compared with the corresponding UK cohorts for demographics using Pearson's chi-squared test for sex and education, and Welch two-sample t test for age. For the cut-scores indicating cognitive impairment, the fifth (95th) percentiles and group mean performance score for each scored item were compared using Welch two-sample t tests. The pre-defined criteria for retaining OCS cut-scores had no statistically significant difference in either percentile or group mean scores for each scored item. RESULTS Participants (n = 83) were recruited: fifty-eight completed version A [age (years) mean = 61,SD = 15; 62% female], 60 completed version B [age (years) mean = 62,SD = 13, 53% female], and 35 completed both [age (years) mean = 64,SD = 11, 54% female]. Education was different between the cohorts for version B (12 years, p = 0.002). Cut-scores for all 16 scored items for the OCS-AU version B and 15/16 for version A met our pre-defined criteria for retaining the OCS cut scores. CONCLUSIONS The OCS-AU provides clinicians with an Australian-specific, first-line cognitive screening tool for people after stroke. Early screening can guide treatment and management.
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Affiliation(s)
- Colette Sanctuary
- Hunter Stroke Service, Hunter New England Local Health Service, New Lambton Heights, NSW, Australia.,Belmont Hospital, Hunter New England Local Health, Belmont, NSW, Australia
| | - Luisa Hewitt
- Hunter Stroke Service, Hunter New England Local Health Service, New Lambton Heights, NSW, Australia.,Belmont Hospital, Hunter New England Local Health, Belmont, NSW, Australia
| | - Nele Demeyere
- Translational Neuropsychology Research Group, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kirsti Kankkunen
- Hampstead Rehabilitation Centre, Central Adelaide Local Health Network, SA Health, Lightview, SA, Australia
| | - D Vincent Oxenham
- School of Psychological Sciences, Macquarie University, Sydney, Australia.,Neurology Department, Royal North Shore Hospital, Sydney, Australia
| | - Dawn B Simpson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Heart and Stroke Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Artemis Synn
- Hampstead Rehabilitation Centre, Central Adelaide Local Health Network, SA Health, Lightview, SA, Australia
| | - Sam S Webb
- Translational Neuropsychology Research Group, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Dianne L Marsden
- Hunter Stroke Service, Hunter New England Local Health Service, New Lambton Heights, NSW, Australia.,Heart and Stroke Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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Huygelier H, Schraepen B, Miatton M, Welkenhuyzen L, Michiels K, Note E, Lafosse C, Thielen H, Lemmens R, Bruffaerts R, Demeyere N, Gillebert CR. The Dutch Oxford Cognitive Screen (OCS-NL): psychometric properties in Flemish stroke survivors. Neurol Sci 2022; 43:6349-6358. [DOI: 10.1007/s10072-022-06314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
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Iosa M, Demeyere N, Abbruzzese L, Zoccolotti P, Mancuso M. Principal Component Analysis of Oxford Cognitive Screen in Patients With Stroke. Front Neurol 2022; 13:779679. [PMID: 35711263 PMCID: PMC9197217 DOI: 10.3389/fneur.2022.779679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits occur in most patients with stroke and are the important predictors of adverse long-term outcome. Early identification is fundamental to plan the most appropriate care, including rehabilitation and discharge decisions. The Oxford Cognitive Screen (OCS) is a simple, valid, and reliable tool for the assessment of cognitive deficits in patients with stroke. It contains 10 subtests, providing 14 scores referring to 5 theoretically derived cognitive domains: attention, language, number, praxis, and memory. However, an empirical verification of the domain composition of the OCS subtests in stroke data is still lacking in the literature. A principal component analysis (PCA) was performed on 1,973 patients with stroke who were enrolled in OCS studies in the UK and in Italy. A number of six main components were identified relating to the domains of language and arithmetic, memory, visuomotor ability, orientation, spatial exploration, and executive functions. Bootstrapped split-half reliability analysis on patients and comparison between patients and 498 healthy participants, as that between patients with left and right hemisphere damage, confirmed the results obtained by the principal component analysis. A clarification about the contribution of each score to the theoretical original domains and to the components identified by the PCA is provided with the aim to foster the usability of OCS for both clinicians and researchers.
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Affiliation(s)
- Marco Iosa
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Mauro Mancuso
- Tuscany Rehabilitation Clinic, Arezzo, Italy.,Physical and Rehabilitative Medicine Unit, NHS-USL Tuscany South-Est, Grosseto, Italy
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Valério D, Almeida J, Demeyere N, Lima M, Nogueira J, Santana I. The European Portuguese version of the Oxford Cognitive Screening (OCS-Pt): a screening test for acute stroke patients. Neurol Sci 2022; 43:3717-3728. [DOI: 10.1007/s10072-022-05880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022]
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Bisogno AL, Favaretto C, Zangrossi A, Monai E, Facchini S, De Pellegrin S, Pini L, Castellaro M, Basile AM, Baracchini C, Corbetta M. A low-dimensional structure of neurological impairment in stroke. Brain Commun 2021; 3:fcab119. [PMID: 34136813 PMCID: PMC8204367 DOI: 10.1093/braincomms/fcab119] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/03/2021] [Accepted: 06/01/2021] [Indexed: 12/18/2022] Open
Abstract
Neurological deficits following stroke are traditionally described as syndromes related to damage of a specific area or vascular territory. Recent studies indicate that, at the population level, post-stroke neurological impairments cluster in three sets of correlated deficits across different behavioural domains. To examine the reproducibility and specificity of this structure, we prospectively studied first-time stroke patients (n = 237) using a bedside, clinically applicable, neuropsychological assessment and compared the behavioural and anatomical results with those obtained from a different prospective cohort studied with an extensive neuropsychological battery. The behavioural assessment at 1-week post-stroke included the Oxford Cognitive Screen and the National Institutes of Health Stroke Scale. A principal component analysis was used to reduce variables and describe behavioural variance across patients. Lesions were manually segmented on structural scans. The relationship between anatomy and behaviour was analysed using multivariate regression models. Three principal components explained ≈50% of the behavioural variance across subjects. PC1 loaded on language, calculation, praxis, right side neglect and memory deficits; PC2 loaded on left motor, visual and spatial neglect deficits; PC3 loaded on right motor deficits. These components matched those obtained with a more extensive battery. The underlying lesion anatomy was also similar. Neurological deficits following stroke are correlated in a low-dimensional structure of impairment, related neither to the damage of a specific area or vascular territory. Rather they reflect widespread network impairment caused by focal lesions. These factors showed consistency across different populations, neurobehavioural batteries and, most importantly, can be described using a combination of clinically applicable batteries (National Institutes of Health Stroke Scale and Oxford Cognitive Screen). They represent robust behavioural biomarkers for future stroke population studies.
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Affiliation(s)
| | - Chiara Favaretto
- Department of Neuroscience, University of Padova, Padova 35100, Italy
| | - Andrea Zangrossi
- Department of Neuroscience, University of Padova, Padova 35100, Italy
| | - Elena Monai
- Department of Neuroscience, University of Padova, Padova 35100, Italy
| | - Silvia Facchini
- Department of Neuroscience, University of Padova, Padova 35100, Italy
| | | | - Lorenzo Pini
- Padova Neuroscience Center (PNC), University of Padova, Padova 35100, Italy
| | - Marco Castellaro
- Department of Information Engineering, University of Padova, Padova 35100, Italy
| | | | | | - Maurizio Corbetta
- Department of Neuroscience, University of Padova, Padova 35100, Italy
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Huygelier H, Schraepen B, Demeyere N, Gillebert CR. The Dutch version of the Oxford Cognitive Screen (OCS-NL): normative data and their association with age and socio-economic status. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:765-786. [PMID: 31684814 DOI: 10.1080/13825585.2019.1680598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Oxford Cognitive Screen (OCS) is a screening tool designed for stroke patients, assessing attention, executive functions, language, praxis, numeric cognition and memory. Here we present norms for the two parallel versions of the Dutch OCS (OCS-NL, acquired in 246 participants for version A and a subset of 179 participants for version B. We evaluated the association of age and socio-economic status (i.e. education, income, occupation) with OCS-NL performance There were no systematic performance differences between income groups, nor between manual and non-manual workers. There were small differences between education groups. The association of education and performance did not vary across subtests. The association of age and performance varied across subtests, with the strongest associations for the naming, praxis, verbal memory and executive task. Thus, OCS-NL norms do not need to be stratified on income and occupation and age-specific norms are recommended for some subtests.
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Affiliation(s)
- Hanne Huygelier
- Department for Brain and Cognition, KU Leuven , Leuven, Belgium
| | | | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford , Oxford, UK
| | - Céline R Gillebert
- Department for Brain and Cognition, KU Leuven , Leuven, Belgium.,Department of Experimental Psychology, University of Oxford , Oxford, UK
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