The influence of language comprehension proficiency on assessment of global cognitive impairment following Acquired Brain Injury: a comparison between MMSE, MoCA and CASP batteries

Language disorders are among the primary obstacles in care and rehabilitation process following acquired brain injuries (ABI). While early cognitive screening is considered critical for sketching a reliable picture of patients' residual abilities and devising efficient therapeutic plans, it has been shown that commonly-used screening tools-which strongly rely on verbal materials-might be inappropriate when used with ABI patients. This study aimed at testing the robustness and validity of the Cognitive Assessment for Stroke Patients (CASP) battery-devised to minimize the use of verbal materials-and two gold-standards in clinical practice-i.e. Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA)-in presence of language comprehension difficulties. Forty-two ABI patients took part in the study. Half of the cohort was classified as aphasic. Participants underwent neuropsychological assessment including MMSE, MoCA and CASP, and completed the Token test to estimate language comprehension proficiency. The influence of linguistic ability on the outcomes of the screening tools was investigated. Regression analyses highlighted that, in aphasic patients, MMSE and MoCA scores proved to be significantly and remarkably determined by patients' proficiency in linguistic comprehension, while the outcome of the CASP battery was not significantly affected by language comprehension impairments.