Abstract
Background With the Stroop-Interference-NoGo-Test (STING), we introduce an efficient and sensitive screening tool for the assessment of mild to moderate cognitive impairment. Its development was motivated by the ongoing economization of diagnostics and therapy in clinics as well as by the increased recognition of the effects of cognitive impairments on quality of life and professional reintegration. Established screenings such as the MoCA, MMSE and CAMCOG are either more time-consuming or lack sensitivity with regard to mild to moderate impairments in relevant domains.
Methods STING is based on the idea of an omnibus test. It integrates attentional, lexical-semantic, speed- and inhibitory components. In this way, a basic sensorimotor component is separated from a higher-order cognitive/executive component, which allows for differentiation between cognitive and generalised or merely sensorimotor impairments. The norms are based on data from 907 participants (386 M, 521 F). Its discriminative power was investigated in 64 patients (32 M, 32 F) with heterogeneous, but predominantly mild to moderate neuropsychological impairments.
Results The split-half reliability is essentially r=0.82–0.95. For the parallel-test reliability, the index is r=0.82–0.91, whereas the test-retest stability is estimated somewhat lower (r=0.48–0.81). Practice effects are moderate (7–12%). STING is correlated with many familiar tests, but sets itself apart from mere intelligence testing. Within the age category of 12–34 years, the number of correct items in the more complex second half of the test was predictive for clinical caseness, with a sensitivity of 83% and a specificity of 47%. Between the ages of 35 and 64, the classification was improved by the combination with the ratio of both halves, which represents set-shifting costs. Here the sensitivity of 71% goes hand in hand with a specificity of 70%.
Discussion STING provides a measure that can be considered sufficiently sensitive for use in the global assessment of cognitive impairment. A positive result does not replace a neuropsychological assessment, but indicates the need for one. The test offers an opportunity to neurologists, psychologists and psychiatrists to objectify mild to moderate, transient, or chronic functional impairments and to evaluate their course over time.
A change of cerebral perfusion of patients with chronic neuropsychological impairments before and after a daytreatment group rehabilitation
