Abstract Details

Title Cognitive disorder and depression screening in acute stroke.

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-002

Objective

We launched a dedicated process to identify invisible disabilities after stroke. Hypothesis. >50% of acute stroke patients have cognitive deficits, or depression.

Background 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. Previously ~70% of acute stroke survivors were reported to be limited in activities and independence because of cognitive deficits or depression.

Design/Methods Methods. Our comprehensive stroke center instituted bedside psychometric assessment 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). This includes spatial neglect/delirium assessment (observations) in patients who cannot respond verbally.

Results Results. 105 ischemic stroke survivors were assessed in April-July, 2021: women (n = 44; average age 63.9 years; 1 Latina; 25 Black/AA, 2 Asian, 1 Native, 1 unknown, 15 white; 0 veterans) and men (n = 61; average 66.9 years; 1 Latino, 28 Black/AA, 2 Asian, 2 unknown, 29 white; 21 veterans). NIHSS average 7.0, SD 7.26 (women) and 4.5, SD 5.33 (men). Patients met criteria for spatial neglect (47%), aphasia (40%), delirium (19%) and depression (31%); >90% had memory / global cognitive impairment (MoCA<26/30).

Conclusions Conclusions. Our systematic spatial neglect, aphasia, memory and global cognitive, delirium and depression screening, confirmed previously reported high post-stroke rates of cognitive disorders and depression. We are currently implementing 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).

Authors/Disclosures
A. M. Barrett, MD, FAAN (UMass Memorial) PRESENTER	The institution of Dr. Barrett has received research support from Veterans Health Association. The institution of Dr. Barrett has received research support from National Institutes of Health. The institution of Dr. Barrett has received research support from Mabel H Flory Trust. Dr. Barrett has received personal compensation in the range of $0-$499 for serving as a author, chapter with WebMD. Dr. Barrett has received personal compensation in the range of $10,000-$49,999 for serving as a scientific advisor with Winifred Masterson Burke Foundation.
	No disclosure on file
David W. Loring, PhD, FAAN	Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE. The institution of Dr. Loring has received research support from NIH. Dr. Loring has received publishing royalties from a publication relating to health care.
	No disclosure on file
Karima Benameur, MD (Emory University)	Dr. Benameur has nothing to disclose.
Felicia Goldstein	No disclosure on file
	No disclosure on file
Fadi B. Nahab, MD	Dr. Nahab has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Consultation. Dr. Nahab has received intellectual property interests from a discovery or technology relating to health care.

��ɫ��

��ɫ��