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Title: An assessment of cognition in healthy individuals to inform the assessment of cognition in transient ischemic attack patients
Author: Lambert, Danielle
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2017
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It is known that people can suffer from cognitive impairments following a TIA. Yet, currently, the methods for measuring this impairment are not very accurate or feasible. Whilst there is a gold standard battery to test for cognitive impairment, there are no up-to-date cohesive UK norms. Furthermore, current screening tools, it has been shown, have ceiling effects, and they are not sensitive in detecting mild cognitive impairments seen in a TIA profile. This study aims to explore whether a brief battery (BICAMS), which is used in MS could be an improvement on current tools. The sensitivity and specificity of the BICAMS were compared with a gold standard measure of cognitive impairment in TIA (NINDS-VCI; Hachinski et al., 2006). Furthermore, the study develops cohesive UK norms for the full NINDS-VCI battery to determine whether these would provide different outcomes to the available norm sources. Sixty-seven healthy UK participants were recruited to complete a 90-minute battery of tests - the MoCA, MMSE, BICAMS and NINDS-VCI 60-minute battery and a measure of estimated IQ, fatigue, anxiety and depression. Different norm sources were compared for the NINDS-VCI battery (published and current study). The numbers of participants falling below the expected level on the NINDS-VCI battery were compared with those identified by the three different screening tools. Finally, regression analyses were conducted to show which clinical and demographic factors contributed to performance on the NINDS-VCI and BICAMS. The study found that different numbers of participants fell below the expected levels on the NINDS-VCI battery, depending on which norm sources were used, with a trend towards more participants being identified with published norms. Years of education was a significant predictor of NINDS-VCI scores and age was a significant unique contributor to BICAMS scores. BICAMS significantly correlated with NINDS-VCI performance and was found to be more sensitive and specific than the MoCA or MMSE. Relevant and up-to date cohesive norms are important to evaluate performance accurately on the NINDS-VCI-VCI 60-minute battery. BICAMS shows promise as a suitable screening tool to measure mild cognitive impairment after a TIA. Further research should focus on comparing TIA participants with UK matched controls.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available