Screening for Stroke and Cognitive Impairment

Chapter 6: Interpretation

Interpretation of the Abnormal Score

• Screening is for case finding for further cognitive evaluation

• Sensitivity & Specificity is never 100% in comparison to the gold standard of formal neuropsychological evaluation.

• Corroborating concerns regarding a patient’s cognition with problems in their daily social or occupational function is also important.

• A more comprehensive cognitive evaluation is then warranted.

What’s Next?

Canadian Best Practice Recommendation for Stroke Care 7.2.1:http://www.strokebestpractices.ca/index.php/cognition-mood/vascular cognitive-impairment-and-dementia/

“Patients who demonstrate cognitive impairments in the screening process should be managed by a healthcare professional with expertise in the assessment and management of neurocognitive functioning.*

This assessment should include cognition, perception and/or function as appropriate to guide comprehensive management.

* Experts in neurocognitive assessment may include: A neuropsychologist, psychologist, occupational therapist, speech-language pathologist, clinical nurse specialist, psychiatrist, physiatrist, geriatrician, neurologist, and developmental pediatricians.”1

What’s Next?

Canadian Best Practice Recommendation for Stroke Care 7.2.1:http://www.strokebestpractices.ca/index.php/cognition-mood/vascular cognitive-impairment-and-dementia/

“Additional assessments should be undertaken to determine: the nature and severity of cognitive impairments; the presence of remaining cognitive abilities and strengths.

The impact of deficits on function and safety in activities of daily living and instrumental activities of daily living, and occupational and school functioning should also be assessed.

The results of these assessments should be used to guide selection and implementation of appropriate remedial, compensatory and/or adaptive intervention strategies according to client-centred goals and current or anticipated living.”1