When assessing cognitive functions after stroke is it best to get an overview of general functioning or should clinicians look at specific abilities? The findings of Dr. Sofia Massa and colleagues, from the Universities of Oxford and Birmingham, suggest that it is best to mix these two approaches to construct an informative cognitive profile.

Cognitive impairment is common following stroke and characterizing patients functioning is crucial for determining care needs. Clinicians often have a choice between cognitive assessments that give a quick overview of functioning or those that sample a few specific domains, thereby running the risk of missing a specific deficit.

The team of researchers wanted to assess the relative merits of the general and specific approaches to cognitive assessment. In order to do this they used the Birmingham Cognitive Screen, or BCoS, which had been previously designed to cover a range of cognitive domains in a relatively short time period. The BCoS contains a number of measures tapping five broad cognitive domains: i) the ability to control attention and ignore irrelevant information, otherwise known as executive functioning, ii) spoken and written language, iii) memory over both short and long delays, iv) numerical skills, and v) the ability to plan and coordinate movements, also known as praxis.

They collected data from 287 stroke patients who each completed the BCoS. Their analysis technique, known as graphical modeling, allowed them to assess associations between performance on tests from the same cognitive domain (specific) as well as relationships between tests from different domains (general).

Some of the tests in the BCoS stood out as good indicators of general cognitive functioning. For example, one test of executive functioning — -in which patients listened to a sequence of words, some that required responses and others that were to be ignored — -predicted performance on a range of tasks from different domains.

Tests like this may be useful for a quick assessment of cognitive function, they suggest. Given the heterogeneous nature of cognitive deficit following stroke the authors note that the importance of specific domains should not be overlooked. What is clear from their analysis, however, is that to understand specific deficits it is necessary to gauge the general level of functioning.

The work of Massa and colleagues has clear implications; in order to best characterize the cognitive function of patients following stroke it is important to look at general functioning as well as specific domains. Measures like the BCoS, which sample a variety of functions in a time efficient manner, provide a cognitive profile with which to assess this.

For further information

Read the Cortex original research article which this summary is based on On the importance of cognitive profiling: A graphical modelling analysis of domain-specific and domain-general deficits after stroke (June 2015).

Visit the profile of the research ambassador, Stephen Rhodes, who wrote this summary.

STM Digest is a collection of lay summaries published next to original research articles on ScienceDirect, provided free of charge, and accessible to everyone.