Ann Rehabil Med.  2024 Feb;48(1):22-30. 10.5535/arm.23149.

The Korean Version of the Oxford Cognitive Screen (K-OCS) Normative Study

• Cho E
• Choi S
• Demeyere N
• Hwang SSS
• Kim M

• KMID: 2553158
• DOI: http://doi.org/10.5535/arm.23149

Abstract

Objective
To generate a Korean version of the Oxford Cognitive Screen (K-OCS) and obtain cutoff scores that determine the impairment of each subdomain. Post-stroke cognitive impairment (PSCI) negatively impacts the rehabilitation process and independence in daily life. Its obscure manifestations require effective screening for appropriate rehabilitation. However, in most rehabilitation clinics, psychological evaluation tools for Alzheimer’s dementia have been used without such considerations. The OCS is a screening assessment tool for PSCI and vascular dementia that can evaluate the cognitive domains most often affected by stroke, including language, attention, memory, praxis, and numerical cognition. It comprises 10 subtasks and enables quick and effective cognitive evaluation.
Methods
The K-OCS, which considers Korea’s unique cultural and linguistic characteristics, was developed with the approval and cooperation of the original author. Enrollment of participants without disabilities was announced at Duksung Women’s University, Yongin Sevrance Hospital, CHA Bundang Medical Center. The study was conducted between September 2020 and March 2022 on 97 male and female participants aged ≥30 years.
Results
All the 97 participants completed the task. In this study, the 5th percentile score was presumed to be the cutoff value for each score, and the values are provided here. The cutoff score for each OCS subtask was similar to that of the original British version.
Conclusion
We suggest the usability of the K-OCS as a screening tool for PSCI by providing the cutoff value of each subtask.

Keyword

Oxford Cognitive Screen; Cognition; Domain; Stroke; Neuropsychological assessment

Figure

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  Fig. 1. Visual snapshot Korean version of the Oxford Cognitive Screen (K-OCS) cognitive profile. EXEC, executive.

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Reference

1. Kim JY, Kang K, Kang J, Koo J, Kim DH, Kim BJ, et al. Executive summary of Stroke Statistics in Korea 2018: a report from the Epidemiology Research Council of the Korean Stroke Society. J Stroke. 2019; 21:42–59.

2. Rost NS, Brodtmann A, Pase MP, van Veluw SJ, Biffi A, Duering M, et al. Post-stroke cognitive impairment and dementia. Circ Res. 2022; 130:1252–71.

3. Jaillard A, Naegele B, Trabucco-Miguel S, LeBas JF, Hommel M. Hidden dysfunctioning in subacute stroke. Stroke. 2009; 40:2473–9.

4. Rasquin SM, Lodder J, Ponds RW, Winkens I, Jolles J, Verhey FR. Cognitive functioning after stroke: a one-year follow-up study. Dement Geriatr Cogn Disord. 2004; 18:138–44.

5. Hoffmann M. Higher cortical function deficits after stroke: an analysis of 1,000 patients from a dedicated cognitive stroke registry. Neurorehabil Neural Repair. 2001; 15:113–27.

6. Leśniak M, Bak T, Czepiel W, Seniów J, Członkowska A. Frequency and prognostic value of cognitive disorders in stroke patients. Dement Geriatr Cogn Disord. 2008; 26:356–63.

7. Ballard C, Stephens S, Kenny R, Kalaria R, Tovee M, O'Brien J. Profile of neuropsychological deficits in older stroke survivors without dementia. Dement Geriatr Cogn Disord. 2003; 16:52–6.

8. Dobrow MJ, Hagens V, Chafe R, Sullivan T, Rabeneck L. Consolidated principles for screening based on a systematic review and consensus process. CMAJ. 2018; 190:E422–9.

9. Quinn TJ, Elliott E, Langhorne P. Cognitive and mood assessment tools for use in stroke. Stroke. 2018; 49:483–90.

10. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12:189–98.

11. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005; 53:695–9. Erratum in: J Am Geriatr Soc 2019;67:1991.

12. Burton L, Tyson SF. Screening for cognitive impairment after stroke: a systematic review of psychometric properties and clinical utility. J Rehabil Med. 2015; 47:193–203.

13. Kosgallana A, Cordato D, Chan DKY, Yong J. Use of cognitive screening tools to detect cognitive impairment after an ischaemic stroke: a systematic review. SN Compr Clin Med. 2019; 1:255–62.

14. Zhang H, Zhang XN, Zhang HL, Huang L, Chi QQ, Zhang X, et al. Differences in cognitive profiles between traumatic brain injury and stroke: a comparison of the Montreal Cognitive Assessment and Mini-Mental State Examination. Chin J Traumatol. 2016; 19:271–4.

15. Demeyere N, Riddoch MJ, Slavkova ED, Bickerton WL, Humphreys GW. The Oxford Cognitive Screen (OCS): validation of a stroke-specific short cognitive screening tool. Psychol Assess. 2015; 27:883–94.

16. Moore MJ, Demeyere N. Lesion symptom mapping of domain-specific cognitive impairments using routine imaging in stroke. Neuropsychologia. 2022; 167:108159.

17. Demeyere N, Riddoch MJ, Slavkova ED, Jones K, Reckless I, Mathieson P, et al. Domain-specific versus generalized cognitive screening in acute stroke. J Neurol. 2016; 263:306–15.

18. Mancuso M, Varalta V, Sardella L, Capitani D, Zoccolotti P, Antonucci G; Italian OCS Group. Italian normative data for a stroke specific cognitive screening tool: the Oxford Cognitive Screen (OCS). Neurol Sci. 2016; 37:1713–21.

19. Kong AP, Lam PH, Ho DW, Lau JK, Humphreys GW, Riddoch J, et al. The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2016; 23:530–48.

20. Shendyapina M, Kuzmina E, Kazymaev S, Petrova A, Demeyere N, Weekes BS. The Russian version of the Oxford Cognitive Screen: validation study on stroke survivors. Neuropsychology. 2019; 33:77–92.

21. Robotham RJ, Riis JO, Demeyere N. A Danish version of the Oxford cognitive screen: a stroke-specific screening test as an alternative to the MoCA. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2020; 27:52–65.

22. Valério D, Almeida J, Demeyere N, Lima M, Nogueira J, Santana I. The European Portuguese version of the Oxford Cognitive Screening (OCS-Pt): a screening test for acute stroke patients. Neurol Sci. 2022; 43:3717–28.

23. Huygelier H, Schraepen B, Miatton M, Welkenhuyzen L, Michiels K, Note E, et al. The Dutch Oxford Cognitive Screen (OCS-NL): psychometric properties in Flemish stroke survivors. Neurol Sci. 2022; 43:6349–58.

24. Sanctuary C, Hewitt L, Demeyere N, Kankkunen K, Oxenham DV, Simpson DB, et al. The Oxford Cognitive Screen for use with Australian people after stroke (OCS-AU): the adaptation process and determining cut scores for cognitive impairment using a cross-sectional normative study. Aust Occup Ther J. 2023; 70:73–85.

25. West SG, Finch JF, Curran PJ. Structural equation models with nonnormal variables: problems and remedies. In : Hoyle RH, editor. Structural equation modeling: concepts, issues, and applications. Sage Publications;1995. p. 56–75.

26. Demeyere N. Oxford Cognitive Screen translation and linguistic validation process. Oxford University Innovation;2016.

27. Kim HS. Korean Language Use of Frequency. National Institute of Korean Language;2005.

28. Christensen KJ, Multhaup KS, Nordstrom S, Voss K. A cognitive battery for dementia: development and measurement characteristics. Psychol Assess J Consult Clin Psychol. 1991; 3:168–74.

29. Kang YW, Park JS, Yu KH, Lee BC. A reliability, validity, and normative study of the Korean-Montreal Cognitive Assessment(K-MoCA) as an instrument for screening of Vascular Cognitive Impairment(VCI). Korean J Clin Psychol. 2009; 28:549–62.

30. Lim SY, Lee EJ, Jeong SW, Kim HC, Jeong CH, Jeon TY, et al. The validation study of beck depression scale 2 in Korean version. Anxiety Mood. 2011; 7:48–53.

31. Milosevich ET, Moore MJ, Pendlebury ST, Demeyere N. Domain-specific cognitive impairment 6 months after stroke: the value of early cognitive screening. Int J Strok. 2023. doi: 10.1177/17474930231205787 [Epub ahead of print].