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Cognitive assessment scale for stroke patients (CASP): A multicentric validation study - 12/05/22

Doi : 10.1016/j.rehab.2021.101594 
Charles Benaim a, b, , Grégoire Wauquiez c, Dominic Pérennou d, e, Céline Piscicelli d, e, Brigitte Lucas-Pineau f, Huei-Yune Bonnin-Koang g, Philippe Vuadens b, Christine Binquet h, Abderrahmane Bourredjem h, Hervé Devilliers h
a Physical Medicine and Rehabilitation, Lausanne University Hospital and University of Lausanne, Avenue Pierre Decker 4, CH-1011, Switzerland 
b Clinique Romande de Réadaptation - SuvaCare, Sion, Switzerland 
c Physical Medicine and Rehabilitation, Dijon University Hospital, France 
d Neurorehabilitation Department, Institute of Rehabilitation, Grenoble Alpes University Hospital, Echirolles 38434, France 
e Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105, Université Grenoble Alpes, Grenoble, France 
f Centre de Rééducation Fonctionnelle Divio, Dijon, France 
g Neurorehabilitation, Nîmes University Hospital, France 
h Centre d'Investigation Clinique CIC 1432 and University of Bourgogne-Franche-Comté, France 

Corresponding author at: Physical Medicine and Rehabilitation, Lausanne University Hospital and University of Lausanne, Avenue Pierre Decker 4, CH-1011, Switzerland.Physical Medicine and RehabilitationLausanne University Hospital and University of LausanneAvenue Pierre Decker 4CH-1011Switzerland

Highlights

The Cognitive Assessment scale for Stroke Patients (CASP) is a rapid test for screening for post-stroke cognitive impairment.
It can be performed at the patient's bedside by a non-expert examiner.
A CASP score of <35/36 should alert to the possible presence of cognitive impairment.
The score can help predict a medium-term cognitive prognosis.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

The Mini Mental State Examination and Montreal Cognitive Assessment are commonly used as short screening batteries for assessing cognitive impairment after stroke. However, aphasia or hemispatial neglect may interfere with the results. For this reason, we developed the Cognitive Assessment scale for Stroke Patients (CASP), which takes these conditions into consideration and previously demonstrated its superiority over these scales in terms of feasibility.

Objectives

Our goal was to verify the psychometric properties of the (original) French version of the CASP.

Methods

We included 201 patients with a recent first hemispheric stroke and 50 controls. Stroke patients were examined 4 times (visit 1 [V1] to visit 4 [V4]) in the subacute post-stroke phase. The structural validity of the CASP was studied by principal factorial analysis, convergent validity by comparison with several variables including a comprehensive neuropsychological assessment, divergent validity by comparison with the total score between stroke patients and controls, and sub-scores between right and left stroke. Internal consistency, reproducibility and sensitivity to change were assessed. We propose the Minimal Clinically Important Difference (MCID) value and a pathological threshold as well as a threshold to predict cognitive change between V1 and V4.

Results

Of the 201 participants included (63% male; mean [SD] age 63 [13] years), CASP data were available for 199/150/133/93 at V1/V2/V3/V4, respectively. CASP has a one-dimensional structure. The hypotheses of convergent/divergent validities were confirmed. Internal consistency was good and reliability excellent. Responsiveness was small to moderate, but the MCID could still be estimated. We discuss the choice of a pathological threshold and a predictive threshold of V1 over V4.

Conclusions

CASP has good psychometric properties for screening cognitive impairment in the subacute post-stroke phase, which is consistent with its Italian and Korean versions. It can be used for patients with severe motor aphasia or left hemispatial neglect but not in case of severe oral comprehension or visual impairment.

Le texte complet de cet article est disponible en PDF.

Keywords : Validation studies, Stroke, Cognitive, Assessment

Abbreviations : ASRS, AUC, BDAE, CASP, CFI, CNA, MCID, MMSE, MoCA, PFA, RMSEA, SEM, SRM, SRMR, TLI


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© 2021  The Author(s). Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 65 - N° 3

Article 101594- mai 2022 Retour au numéro
Article précédent Article précédent
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