Abstract
As a significant number of stroke victims exhibit cognitive impairment, neuropsychological assessments can enhance poststroke management by identifying pertinent cognitive sequelae and providing salient care recommendations. However, due to operational differences between traditional neuropsychology and stroke services, neuropsychological assessments often remain underutilized in stroke care. We developed a novel care model that incorporated neuropsychological testing into a comprehensive stroke program using the modified vascular cognitive impairment (VCI) half-hour assessment protocol proposed by the National Institute of Neurological Disorders and Stroke—Canadian Stroke Network (NINDS-CSN). The test batteries were administered during the patients' acute admissions and then again upon follow-up in the multidisciplinary stroke clinic. Patient and provider satisfaction was then evaluated. Surveys revealed high provider satisfaction with improved clinic efficacy, improved data turnaround time, and with value neuropsychology services added to the comprehensive stroke program. Results from the 18-item industry standard Press-Ganey surveys showed all scores above 4.4/5.0 for patient satisfaction. This clinic garnered high provider and patient satisfaction after the first year. The (modified) NINDS-CSN VCI assessment protocol demonstrated clinical feasibility, suggestive of an efficient method of providing focused neuropsychological services in a clinical setting that otherwise prohibits traditional, comprehensive cognitive assessments.
Highlights
Stroke is one of the leading causes of long-term disability in the world, and in the United States, an average of one stroke occurs every 40 seconds
In addition to the physical disabilities that often follow stroke, the risk factors that make individuals prone to stroke and cerebrovascular disease place them at risk for potentially devastating cognitive impairments [2, 3]
Research has demonstrated that these cognitive impairments are central to poststroke outcomes
Summary
Stroke is one of the leading causes of long-term disability in the world, and in the United States, an average of one stroke occurs every 40 seconds. By this estimate, 795,000 new or recurrent strokes occur each year, with annual direct and indirect cost of cardiovascular disease and stroke in the United States being estimated at $312.6 billion [1]. Cognitive impairment measured 3 months after first-ever stroke has been associated with increased risks of death and disability 4 years later [9]
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