Moderated Poster Australian and New Zealand Stroke Organisation Conference 2025

The Oxford Cognitive Screen (OCS-AU): Validation of a Stroke-Specific Cognitive Screening Tool (123155)

Michal Boneh 1 , Vincent Oxenham 2 3 , Alyssa Sher 2 , Kirsti Kankkunen 4 , Peter New 5 6 , Di Marsden 7 , Colette Sanctuary 7 , Luisa Hewitt 7 , Heather Francis 2 3 , Nele Demeyere 8 , Rene Stolwyk 1
  1. School of Psychological Sciences, Monash University, Clayton, VICTORIA, Australia
  2. School of Psychological Sciences, Lifespan Health and Wellbeing Research Centre, Macquarie University, North Ryde, New South Wales, Australia
  3. Neurology Department, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  4. Psychology Department, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
  5. Department of Medicine, Rehabilitation and Aged Services Program, Kingston Centre, Monash Health, Melbourne, Victoria, Australia
  6. Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  7. Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia
  8. Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom

Background/Aims

The Oxford Cognitive Screen (OCS) is a stroke-specific cognitive screening tool, increasingly being used in clinical practice. Our aim was to determine the sensitivity and specificity of the Australian OCS (OCS-AU) to detect post-stroke cognitive impairment as determined by a gold standard measure of cognition. We also compared the sensitivity and specificity of the OCS-AU with a traditionally used screening measure - the Montreal Cognitive Assessment (MoCA).

 Methods

Stroke survivors (n=53) within 12 weeks of stroke completed the OCS-AU, MoCA and a comprehensive cognitive assessment serving as the gold standard. Impairment was defined as failing any OCS-AU domain, scoring below normative MoCA cutoffs, or failing at least two domains on the comprehensive assessment. Analyses were conducted using R.

 Results

Domain-specific OCS-AU sensitivity ranged from 0.17 (Memory and Executive) to 0.71 (Spatial Attention) and specificity ranged from 0.81 (Spatial Attention) to 0.96 (Praxis). To general cognitive impairment, the OCS-AU showed sensitivity of 0.64 and specificity of 0.56, compared to the MoCA's higher sensitivity (0.82) but lower specificity (0.44).

 Conclusion

Our results suggest that the OCS-AU demonstrates acceptable specificity across domains but variable sensitivity, particularly underperforming in Memory and Executive domains. The MoCA offers higher sensitivity, but lower specificity. Thus, the OCS-AU appears to provide more precise indications of cognitive deficits, with attention to stroke-specific impairments, but may not capture all post-stroke cognitive changes. Research and clinical implications of these findings will be discussed, including potential for assessment protocols to optimise detection and subsequent management of cognitive impairment in stroke survivors.