Sensitivity and Specificity of a Five-Minute Cognitive Screening Test in Patients With Heart Failure

Janette D Cameron, Robyn Gallagher, Susan J Pressler, Skye N McLennan, Chantal F Ski, Geoffrey Tofler, David R Thompson

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


BACKGROUND: Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients.

METHODS: The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen.

RESULTS: In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA <26). Scores on the NINDS-CSN screen ranged from 3-11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88; P < .01; 95% CI 0.83-0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity.

CONCLUSIONS: The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols.

Original languageEnglish
Pages (from-to)99-107
JournalJournal of Cardiac Failure
Issue number2
Early online date18 Sept 2015
Publication statusPublished - Feb 2016


  • Aged
  • Aged, 80 and over
  • Australia
  • Cognition
  • Cognition Disorders
  • Female
  • Heart Failure
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Psychometrics
  • ROC Curve
  • Sensitivity and Specificity
  • Evaluation Studies
  • Journal Article
  • Research Support, Non-U.S. Gov't


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