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Sensitivity and Specificity of a Five-Minute Cognitive Screening Test in Patients With Heart Failure.

Abstract：

BACKGROUND:Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients. METHODS:The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen. RESULTS:In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA <26). Scores on the NINDS-CSN screen ranged from 3-11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88; P < .01; 95% CI 0.83-0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity. CONCLUSIONS:The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Cameron JD,Gallagher R,Pressler SJ,McLennan SN,Ski CF,Tofler G,Thompson DR

doi

10.1016/j.cardfail.2015.08.343

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

99-107

issue

2

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(15)01040-4

journal_volume

22

pub_type

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