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Abstract Details

Evaluation of a Digital Cognitive Self-Assessment Method for Post-Stroke Cognitive Decline
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (11:45 AM-12:45 PM)
13-009
To evaluate the feasibility of using XpressO (digital self-administered cognitive assessment) and compare its detection of PSCD with the Montreal Cognitive Assessment short-form (MoCA-sf) at an outpatient stroke clinic.
Post-stroke cognitive decline (PSCD) is a common stroke complication, and early assessment is crucial. However, outpatient cognitive assessment protocols are inconsistent, leading to missed PSCD diagnoses. A potential solution is the XpressO application, introduced in 2023 by the creators of the MoCA. XpressO’s self-paced design allows patients to complete it while waiting for appointments, hence cognition can be assessed without affecting clinic workflow.

Patients with a history of ischemic or hemorrhagic strokes were included. A score of <12 on the MoCA-sf indicated low cognitive performance. Post-appointment, participants consented and completed a screening survey on stroke risk factors, followed by both MoCA-sf and XpressO assessments. Completion times were recorded and analyzed using R-Studio.
32 patients were enrolled and completed the assessments. A moderate correlation between XpressO and MoCA-sf scores was found(ρ=0.645, p=6.70e-05). When stratified by cognitive function, no significant correlation was observed between XpressO and higher MoCA-sf(≥12) scores(ρ=0.128, p=0.691). Average completion times were 6.63 minutes for MoCA-sf and 6.28 minutes for XpressO, with no significant difference overall. However, in patients with higher cognitive function, XpressO was completed significantly faster(4.43 minutes) than MoCA-sf(5.83 minutes).

The results suggest that XpressO is better at detecting severe cognitive decline but is less sensitive to milder impairments. The time difference in test completion was significant only in patients with higher cognitive function, favoring XpressO in this group. XpressO’s lack of significant correlation with higher MoCA-sf scores makes it less suitable as a standalone tool for PSCD screening in outpatient stroke clinics. XpressO can be used to identify patients at risk for severe PSCD, but higher XpressO scores should not eliminate the possibility of PSCD in patients.
Authors/Disclosures
Ruta Uttarkar
PRESENTER 		Ms. Uttarkar has nothing to disclose.
Antara Gupta Miss Gupta has nothing to disclose.
Erica M. Jones, MD, MPH (UT Southwestern Medical Center) The institution of Dr. Jones has received research support from NIH KL2.