Journal
PRESSE MEDICALE
Volume 52, Issue 4, Pages -Publisher
MASSON EDITEUR
DOI: 10.1016/j.lpm.2023.104207
Keywords
Sickle cell disease; Cognitive screening; Neurocognitive disorder; Rowland Universal Dementia Assessment; Scale; Montreal Cognitive Assessment; Mini mental state examination
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Neurovascular diseases are common complications of sickle cell disease, and have significant impact on patients' quality of life. Guidance on cognitive screening strategies in adults is currently lacking, and further research is needed.
Neurovascular disease such as symptomatic stroke, silent brain infarcts and vascular cognitive impairment are common complications of sickle cell disease (SCD) that can have devastating consequences on quality of life, employment, and social functioning. Early recognition of neurovascular disease is a prerequisite for the timely optimization of medical care and to connect patients to adaptive resources. While cognitive impairment has been well described in children, currently available data are limited in adults. As a result, guidance on the optimal cognitive screening strategies in adults is scarce. We conducted a systematic review to identify the different screening tools that have been evaluated in SCD. A meta-analysis was performed to estimate the prevalence of suspected cognitive impairment in this population. In this qualitative synthesis, we present 8 studies that evaluated 6 different screening tools. Patient characteristics that impacted on cognitive screening performance included age, education level, and a prior history of stroke. We report a pooled prevalence of 38% [14-62%] of suspected cognitive impairment. We discuss the relative benefits and limitations of the different screening tools to help clinicians select an adapted approach tailored to their specific patients' needs. Further studies are needed to establish and validate cognitive screening strategies in patients with diverse cultural and educational backgrounds.(c) 2023 Elsevier Masson SAS. All rights reserved.
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