Abstract WP66: Acute Stroke Screening For Cognitive Disorders And Depression

Abstract

Introduction: As stroke survivors transition from acute to post-acute care, and finally to community settings, the Centers for Disease Control reports ~65% receive NO rehabilitation. Even more receive rehabilitation too late, after critical brain changes for recovery are complete. Stroke survivors with invisible disabilities of cognition and depression are especially vulnerable to experience poor recovery. We launched a dedicated process to identify invisible disabilities. Our long-term objective is to make acute and post-acute, evidence-based intervention accessible. Hypothesis: >50% of acute stroke patients have cognitive deficits, or depression. Methods: Our comprehensive stroke center completes bedside psychometric assessment with standardized instruments for aphasia (Language Screening Test, LAST), spatial neglect (Catherine Bergego Scale, CBS), memory/global cognition (Montreal Cognitive Assessment, MoCA), delirium (3-Minute Diagnostic Interview for the Confusion Assessment Method, 3D-CAM) and depression (Patient health questionnaire, PHQ-8). Patients unable to respond to questions are assessed for spatial neglect and delirium (standardized observations). Results: 105 ischemic stroke survivors were assessed in the first quarter of program launch (April-July, 2021). Of that group, patients met screening criteria for spatial neglect (47%), aphasia (40%), delirium (19%) and depression (31%). Over 90% had memory / global cognitive impairment (MoCA<26/30). Conclusions: Our initiative, which includes systematic acute stroke unit spatial neglect screening, confirmed the previously reported high rate of cognitive disorders and depression (Champod, Eskes, Barrett, 2020). Our current step implements uniform recommendations for patients with deficits, and will examine post-acute outcomes, number receiving rehabilitation and medical follow-up, and treatment disparities (right/left stroke, under-represented groups).