Development and Validation of Neuro-Cognitive Assessment Battery for Stroke Patients (NCABS) in Pakistan

Background & Objective: Post Stroke Cognitive Impairments (PSCI) occur frequently in stroke survivors resulting in devastating consequences affecting daily living of survivors. Currently, there exists scarcity of sound assessment tools for the evaluation of PSCI as most of the commonly used scales offer a number of clinical (requires motor and linguistic skills) and cultural limitations (requires academic exposure). Therefore, current study was aimed at evaluating the efficacy of Neuro-Cognitive Assessment Battery for Stroke patients (N-CABS) in Pakistan.

Methods: The participants were randomized in two groups including clinical and non-clinical group. N-CABS was administered on 61 clinical and 60 non-clinical participants (mean age=45 years; SD=5.55). Both groups were matched on all demographic variables including; age, gender, education and occupation. The psychometric properties of N-CABS were established through a number of robust measures of validity (construct, concurrent and discriminant validity) and reliability (internal consistency and test retest reliability).

Results: The factor analysis suggested a two-factor solution (labeled as Verbal Cognitive Abilities and Visual Cognitive Abilities) for N-CABS explaining 67% of total variance. A significant test-retest reliability was found (α = 0.92, ***p<0.001). The findings of concurrent validity recommended a significant correlation between N-CABS and Montreal Cognitive Assessment (MoCA) (α = 0.82, ***p<0.001). Similarly, discriminant validity also revealed significant group differences to exist on N-CABS (***p<0.001) suggesting N-CABS be able to discriminate between patients and healthy controls.

Conclusion: The results of the current study favor N-CABS as a psychometrically strong screening instrument to screen PSCI in our culture.