Implementation of congitive screening in the stroke patient pathway

Abstract

Introduction: Stroke is a leading cause of disability worldwide, placing a significant burden on healthcare systems and society. The prevalence of post-stroke cognitive impairment ranges between 20% and 80%, but it is often underdiagnosed. Cognitive deficits have a substantial impact on rehabilitation potential, patients' quality of life, and long-term outcomes.

Objective: To highlight the importance of cognitive screening and explore possibilities of implementation in the stroke care pathway. A paradigm shift is desirable, integrating cognitive screening and rehabilitation in local stroke protocols as parts of the stroke care pathway.

Discussion: Stroke is an emergency neurological condition with tight therapeutic time windows, making the identification of cognitive impairment typically feasible only during the hospital's subacute phase. It is crucial to conduct cognitive screening at this stage to identify and address cognitive deficits and achieve optimal functional outcome. The Oxford Cognitive Screen (OCS) is a promising, quick, and easily administered stroke-specific screening test that can aid the early detection and management of cognitive impairments. The Hungarian adaptation of the OCS is underway and will be available for free.

Conclusion: Introducing cognitive screening during the subacute post-stroke period enables systematic cognitive assessment of stroke patients, enhancing patient safety and opening new, previously unavailable opportunities in Hungarian healthcare practice. Early cognitive diagnostics are essential for targeted rehabilitation and cognitive training, which are prerequisites for social reintegration.