Abstract TP090: Prevalence of Post-stroke Cognitive Impairment in Georgia: MoCA versus NINDS-CNS Neuropsychological Battery Study

Background: Post-stroke cognitive impairment (PSCI) is a common complication of ischemic stroke. The data on PSCI in Eastern Europe, including Georgia, is sparse. The goal of this study was to characterize the diagnostic utility of the Georgian version of the National Institute of Neurological Disorders and Stroke–Canadian Stroke Network (NINDS-CSN) neuropsychological battery and the Montreal Cognitive Assessment (MoCA), and to compare their performance in evaluating the prevalence of PSCI in Georgia. Methods: Ischemic stroke patients attending 6-month follow-up visits were studied. The Georgian NINDS-CSN 30-minute battery was compared to the MoCA to diagnose PSCI. A receiver-operator curve (ROC) analysis with the area under the curve (AUC) was used to compare the performance of these two tests for the diagnosis of PSCI. Results: We studied n =175 subjects, n=73 stroke patients, and n=102 healthy persons. The NINDS-CSN battery demonstrated excellent validity with an AUC of 0.86 (95% CI 0.76-0.93, p <0.0001). The threshold z score ≤ 0.397 was characterized by an optimal sensitivity of 90.2% and specificity of 71.9%. Based on this threshold, the prevalence of PSCI at six months was 63.0%. AUC of MoCA was significantly higher compared to NINDS-CSN (difference 0.09; 95% CI 0.016-0.168, p= 0.017). Based on MoCA, the prevalence of PSCI was 50.7%. Conclusion: The prevalence of PSCI in Georgia at six months after stroke was in the range of 50.7- 63.0% depending on the test used. The Georgian version of both tests showed excellent validity. However, given MoCA’s superior performance, in addition to convenience and timing, Georgian MoCA might be a preferable tool for the screening of PSCI in routine clinical practice.