An evaluation of screening measures for cognitive impairment after stroke.

OBJECTIVES To assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. DESIGN A randomized controlled trial. METHODS Stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini-Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive function. Sensitivity and specificity values were calculated for the three screening measures for overall conclusions regarding cognitive impairment reached from a comprehensive assessment. Receiver Operating Characteristic Curves were plotted. CONCLUSION The Mini-Mental State Examination was not a useful screen for memory problems or overall cognitive impairment after stroke. The Sheffield Screening Test for Acquired Language Disorders was an appropriate screen for language problems. The Raven's Coloured Progressive Matrices was appropriate as a screen for perceptual problems and visual inattention but not for executive deficits.