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Published on: September 30, 2020
Cognitive functioning in the acute phase poststroke: a predictor of discharge destination?
Carmen S van der Zwaluw1, Susanne A M Valentijn, Ruth Nieuwenhuis-Mark
1Radboud University, Nijmegen, Behavioural Science Institute, Nijmegen, The Netherlands.
Summary
Cognitive screening after stroke is feasible and improves prediction of discharge destination. Combining cognitive tests with functional status offers a better approach for discharge planning for stroke survivors.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Gerontology
Background:
- Cognitive dysfunction affects over 50% of stroke survivors, impacting daily life.
- Accurate assessment of cognitive function is crucial for determining appropriate post-hospital discharge destinations.
Purpose of the Study:
- To assess the feasibility of cognitive screening in the acute phase after stroke.
- To determine if cognitive screening can predict discharge destination (independent vs. dependent living).
Main Methods:
- 287 first-ever stroke patients underwent screening (Mini-Mental State Examination, Cognitive Screening Test, Clock-Drawing Test) within 7 days.
- Logistic regression analysis was used to evaluate predictive values of functional status and cognitive tests.
Main Results:
- Cognitive screening was feasible in 73.2% of patients.
- The Barthel Index (BI) alone explained 47% of discharge destination variance.
- Adding cognitive tests (BI and CST) increased explained variance to 53%.
Conclusions:
- Cognitive screening in the acute stroke phase is feasible and aids discharge planning.
- Cognitive screening, alongside functional status, significantly improves prediction of discharge destination.
- The Mini-Mental State Examination was not suitable for prediction; a comprehensive predictor set is recommended.
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