Comparison of three cognitive assessment methods in post-stroke aphasia patients

Zhijie Yan; Shuo Xu; Dongshuai Wei; Xinyuan He; Chong Li; Yongli Zhang; Mengye Chen; Jingna Zhang; Xiaofang Li; Qing Yang; Jie Jia

doi:10.3389/fpsyg.2022.896095

Comparison of three cognitive assessment methods in post-stroke aphasia patients

Front Psychol. 2022 Oct 20:13:896095. doi: 10.3389/fpsyg.2022.896095. eCollection 2022.

Authors

Zhijie Yan^{1

2}, Shuo Xu¹, Dongshuai Wei¹, Xinyuan He¹, Chong Li¹, Yongli Zhang¹, Mengye Chen¹, Jingna Zhang², Xiaofang Li², Qing Yang¹, Jie Jia^{1

3}

Affiliations

¹ Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.
² Department of Rehabilitation Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
³ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Abstract

Background: The cognitive level of post-stroke aphasia (PSA) patients is generally lower than non-aphasia patients, and cognitive impairment (CI) affects the outcome of stroke. However, for different types of PSA, what kind of cognitive assessment methods to choose is not completely clear. We investigated the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Non-language-based Cognitive Assessment (NLCA) to observe the evaluation effect of CI in patients with fluent aphasia (FA) and non-fluent aphasia (NFA).

Methods: 92 stroke patients were included in this study. Demographic and clinical data of the stroke group were documented. The language and cognition were evaluated by Western Aphasia Battery (WAB), MoCA, MMSE, and NLCA. PSA were divided into FA and NFA according to the Chinese aphasia fluency characteristic scale. Pearson's product-moment correlation coefficient test and multiple linear regression analysis were performed to explore the relationship between the sub-items of WAB and cognitive scores. The classification rate of CI was tested by Pearson's Chi-square test or Fisher's exact test.

Results: The scores of aphasia quotient (AQ), MoCA, MMSE, and NLCA in NFA were lower than FA. AQ was positively correlated with MoCA, MMSE, and NLCA scores. Stepwise multiple linear regression analysis suggested that naming explained 70.7% of variance of MoCA and 79.9% of variance of MMSE; comprehension explained 46.7% of variance of NLCA. In the same type of PSA, there was no significant difference in the classification rate. The classification rate of CI in NFA by MoCA and MMSE was higher than that in FA. There was no significant difference in the classification rate of CI between FA and NFA by NLCA.

Conclusion: MoCA, MMSE, and NLCA can be applied in FA. NLCA is recommended for NFA.

Keywords: NLCA; cognitive impairment; fluent aphasia; non-fluent aphasia; post-stroke aphasia.