DOMAIN-SPECIFIC PREVALENCE OF PERSISTENT COGNITIVE IMPAIRMENT IN STROKE SURVIVORS: AN INTRODUCTION TO THE OX-CHRONIC STUDY OF LONG-TERM PSYCHOLOGICAL CONSEQUENCES OF STROKE
- Nele Demeyere (United Kingdom)
Abstract
Background And Aims
Understanding the long-term cognitive consequences of stroke is a vital but neglected part of providing effective care for stroke patients. With the advent of stroke specific cognitive screening (e.g. Oxford Cognitive Screen, OCS) it is becoming clear that solely screening for general cognitive impairment overlooks crucial domain-specific impairments in stroke patients. In order to capture the full long-term picture, it is crucial we also understand the domain-specific trajectories and describe the prevalence of persistent domain impairments post-stroke.
Methods
Cognitive profiles of 458 stroke survivors (216 female, mean age 74 years) were examined using the OCS during acute recovery (<2 weeks) and six-month later. We investigated the rates of individuals suffering persistent cognitive impairments (i.e. impaired during acute recovery and remained impaired after six months).
Results
Persistent impairment after six-months was most common for tests related to aphasia (e.g. for picture naming 43% and sentence reading 35% remain impaired). For memory impairments, 24-27% remained impaired while executive function remained impaired in 20% of participants. The tests with the lowest rates of persistent impairment was a measure of semantic understanding at 4%, followed by basic arithmetic ability (15%).
Conclusions
Many domain-specific impairments improve, but a significant number of people have lasting impairments. Examining the prevalence of persistent domain-specific impairments highlights the need to better understand the challenges for individuals recovering from stroke. We argue that there is a clear need for domain-specific assessments in order to tailor interventions and support to the individual needs of patients.