Improving cognitive and mood assessments in stroke

Problems of thinking and memory and problems with mood are common in stroke survivors. The first step towards effective management is recognition and diagnosis. Many different tests for assessing thinking and mood problems are available. Tools that work in a general population may not be suited to the needs of stroke survivors and there is no consensus on which tests to use. We will collate all the scientific studies of differing assessment tools to allow us to compare different strategies and offer guidance for professionals working with stroke survivors. We will then test the most promising assessment tools in stroke units.

Project summary

Cognitive and mood disorders are common stroke sequelae, each affecting approximately one third of stroke-survivors. These complications can impair functional recovery and are important to patients. The importance of cognition and mood is recognised in International guidelines, where their routine assessment is recommended for all stroke-survivors. Many cognitive/mood assessment instruments are available, but at present there is no consensus on optimal measure(s) for use in stroke practice or research.

We are creating a body of work around cognitive and mood assessment in stroke. Components include a systematic literature review, informed by collaboration with the Cochrane Collaboration Dementia and Cognitive Improvement Group; a national questionnaire targeting all Scottish stroke units; analysis of cognitive and mood data from a large registry and diagnostic test accuracy assessments of cognitive and mood screening tools.

This work involves collaboration between ICAMS; Institute Health & Wellbeing; MRC Public Health Unit and Cochrane Dementia and Cognitive Improvement Group.
This work is funded by two grants from Chest Heart and Stroke Scotland and a grant from, the British Geriatric Society. Work began in 2011, data collection is ongoing but already preliminary results have been published and presented at national and international meetings.

References

  1. Lees R, Fearon P, Harrison JK, Broomfield NM, Quinn TJ. Cognitive and mood assessment in stroke research: focussed review of contemporary studies. Stroke. 2012; 43:1678-80.
  2. Quinn TJ, Fearon P, Young C, Noel-Storr A, McShane R, Stott DJ. Diagnostic test accuracy of IQCODE for diagnosis of Alzheimers Disease and other dementias in a community setting. Cochrane Database Systematic Reviews 2012; 9 CD010079.
  3. Lees RA, Broomfield NM, Quinn TJ. Questionnaire assessment of usual practice in mood and cognitive assessment in Scottish stroke units.  Disability and Rehabilitation 2013 May 14 [Epub ahead of print]