Can Cognitive and Perceptual Standardized Test Scores Predict Functional Performance in Adults Diagnosed with Stroke?: A Pilot Study

The Cognistat (neurobehavioural cognitive status exam): Administering the full test in stroke patients for optimal results

BACKGROUND

One of the most commonly administered tools occupational therapists use for stroke patients is the Cognistat, which was designed as a brief screening tool of cognitive functioning. Evaluations in samples of patients have identified a high false-negative rate if the Cognistat is administered using the 'screen metric' approach. Assessing the Cognistat based on its intended design can ensure consistency and accuracy among occupational therapists for this commonly administered tool. Thus, this study examined the accuracy of administering the entire Cognistat in comparison to the screen-metric approach and the factor analytic structure within stroke patients.

METHODS

The full Cognistat was administered to stroke patients receiving inpatient rehabilitation.

RESULTS

Seventy-five patients who experienced a recent stroke met inclusion criteria. An inconsistency between the screen and metric items was found for five of 10 subscales. Additionally, a principal component analysis (PCA) found the Cognistat to be a two factor structure with six of the subscales loading on Factor 1, while the remaining subscales loaded on Factor 2.

CONCLUSIONS

Our findings confirm that occupational therapists should administer the full Cognistat to stroke patients rather than the original screen-metric approach. A two-factor structure was also supported in our results, suggesting that occupational therapists' scoring practices should reflect this finding and use the differentiated score out of 10 rather than a global sum. However, additional research is necessary to consider the clinical and theoretical significance of the Cognistats' subscale clustering.

Are clients' performances on the Rowland Universal Dementia Assessment Scale associated with their functional performance? A preliminary investigation

Introduction

The process of selecting the most appropriate cognitive assessments to use with clients presenting with symptoms of dementia is an important consideration. Are cognitive assessment results associated with the functional performance of clients presenting suspected cognitive decline? The purpose of this study was to investigate whether the Rowland Universal Dementia Assessment Scale was associated with the functional performance of clients with suspected dementia.

Method

A within-subjects quantitative research design was employed whereby a sample of 30 participants suspected of having dementia were recruited from three acute care hospital sites in the Melbourne metropolitan region. The Rowland Universal Dementia Assessment Scale was used to assess participants' cognitive abilities, while the Functional Independence Measure was the functional scale used. Linear regression analyses were completed.

Results

The six Rowland Universal Dementia Assessment Scale items were found to be significantly linked with the Functional Independence Measure total score (adjusted R2 = 0.298, p < 0.05), the Functional Independence Measure ‘cognition’ subscale score (adjusted R2 = 0.349, p < 0.05) and the Functional Independence Measure ‘physical’ subscale score (adjusted R2 = 0.244; p < 0.05).

Conclusion

The Rowland Universal Dementia Assessment Scale appears to be associated with the functional performance of clients with suspected dementia. The findings provide an insight into the link between cognition and everyday functional performance.