Screening instruments are ideal for acute clinical settings because they are easy to apply, fast, inexpensive and sensitive for specific samples. However, there is a need to verify the psychometric properties of screening in stroke patients. Objective: This study investigated the psychometric properties (methodological procedures) of cognitive screening for patients with cerebrovascular diseases. Methods: A systematic review of papers published on PsycINFO, Web of Knowledge, PubMed and Science Direct (2005 to 2016) was performed. Results: A total of 55 articles remained after applying exclusion criteria. The samples ranged from 20 to 657 patients. Most articles evaluated elderly individuals with four to 13 years of education who had experienced ischemic or hemorrhagic stroke. There was a tendency to find evidence of validity for criteria and to analyze the sensitivity/specificity of the instruments. Although the studies frequently used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to seek evidence of validity and reliability, the use of these instruments among stroke patients has been criticized due to their psychometric properties and the neuropsychological functions evaluated. Conclusion: Although there is no gold standard screen for assessing adults post-stroke, instruments devised specifically for this population have shown promise. This review helps both researchers and clinicians to select the most appropriate screen for identifying cognitive impairment in adults post-stroke.

Resumo Neste estudo, investigaram-se efeitos de idade e escolaridade e suas interações no desempenho de adultos no Instrumento de Avaliação Neuropsicológica Breve NEUPSILIN, que avalia orientação têmporo-espacial, atenção, percepção, memória, linguagem, calculias, praxias e funções executivas. Participaram 627 adultos saudáveis (19 a 90 anos), divididos em três grupos, conforme escolaridade (1 a 4, 5 a 8 e 9 anos ou mais de estudo) e em quatro grupos por idade (19 a 39, 40 a 59, 60 a 75 e 76 a 90 anos). Encontraram-se efeitos de idade e escolaridade em atenção, percepção, memória (de trabalho, verbal episódica, semântica, visual e prospectiva), linguagem oral e escrita, praxias e funções executivas. Interações entre idade e escolaridade foram encontradas em atenção, memória verbal, linguagem oral e escrita. Os resultados destacam que o envelhecimento e a escolaridade impactam de forma heterogênea nas funções cognitivas, assim como os testes neuropsicológicos brasileiros devem sempre considerar a influência dessas variáveis para produzir seus dados normativos.

Key words: agraphia; cognitive neuropsychology; written language; cerebral dominance

This study aimed to develop a short version of an instrument to detect cognitive impairment in stroke patients, investigate which cognitive dimensions best discriminate between stroke patients and healthy adults and to graphically analyze the relationships among the neuropsychological variables and groups. This pilot study included 94 adults (49 post-stroke and 45 neurologically healthy) who answered the Brief Neuropsychological Assessment Battery NEUPSILIN for patients with expressive aphasia (NEUPSILIN-Af) to assess orientation, perception, memory, praxis, executive functions, oral language, and academic achievement (written language and arithmetic). The IRT Rasch model for dichotomous data indicated the exclusion of items that could not be used to discriminate performances. ROC curves indicated that only the orientation, oral language, academic achievement, and executive function dimensions could be used to differentiate between the clinical and healthy groups. Graphical analysis indicated that independently of the relation among variables, orientation and executive functions tasks are essentials in the neuropsychological assessments. This study contributes to the development of specific and sensitive neuropsychological instruments to assess stroke patients and to better understand the common deficits present in this clinical population.