The Sentinel Stroke National Audit Programme (SSNAP) monitors whether assessment of cognition is included during routine six-month review prior to secondary care discharge, but the nature of the assessment and care pathway is not mandated. The Intercollegiate Stroke Working party recommends a collaborative model between primary and secondary care for long-term follow-up of those presenting with neuropsychological problems. Stroke care in the United Kingdom has been shaped by the National Service Framework for Older People (2001) and the National Stroke strategy (2007) although these do not specifically propose service organisation for patients with cognitive impairment. These cognitive deficits are not necessarily dictated by the severity of stroke and can also occur in transient or minor strokes. Further, 10 % of individuals develop dementia soon after their first stroke and at least 30 % have dementia after recurrent stroke. After stroke around one in three individuals will sustain some degree of cognitive impairment and memory deficits are commonly encountered even when physical recovery is gained. Indeed, one in three people will experience stroke, dementia or both at some stage in their lives. This is not only a result of effects on motor function but because stroke is also associated with cognitive impairment and an increased risk of dementia. Stroke is a leading cause of morbidity worldwide and the third most common cause of disability. Service development should focus on increased cohesiveness between hospital and community care to create a clear care pathway for post-stroke cognitive impairment. This is made even more difficult by the lack of experience in assessment and stigma surrounding potential diagnoses associated with these deficits. Clinicians are unsure who should take responsibility for follow-up of patients with cognitive problems. The care provided by stroke services is dominated by physical impairments. Facilitators included stronger links between primary and secondary care in addition to information provision at all stages of care. Resultsĭata analysis identified four key themes as barriers to optimal care for stroke-survivors with memory difficulties: 1) Less focus on memory and cognition in post-stroke care 2) Difficulties bringing up memory and cognitive problems post-stroke 3) Lack of clarity in current services and, 4) Assumptions made by healthcare professionals introducing gaps in care. Transcripts were thematically analysed and themes grouped into broad categories to facilitate interpretation. Interviews were audio recorded and transcribed verbatim. Topics included individual experiences of the current care offered to patients with cognitive impairment, assessment processes and inter-professional communication. This included stroke medicine specialists, specialist nurses, physiotherapists, occupational therapists, general practitioners and primary care nurses. Seventeen semi-structured individual interviews were conducted by a single interviewer with both primary and secondary care clinicians in regular contact with stroke-survivors. This study critically evaluated the views of healthcare professionals about barriers and facilitators to their care. Despite national clinical guidelines, the service provided for stroke survivors with cognitive and memory difficulties varies across localities. An optimal therapeutic program that would help stroke patients enjoy additional years with higher quality of life is presented.ĭementia memory neuropsychological assessment vascular dementia.Stroke is a common cause of physical disability but is also strongly associated with cognitive impairment and a risk for future dementia. The proposed PSMA is expected to assess different types of memory functionalities that are related to different parts of the brain according to stroke location. This review aims to combine available neuropsychological assessments to develop a post-stroke memory assessment (PSMA) scheme based on the most recognized and available studies. This review starts with stroke types and risk factors associated with dementia development, followed by a brief description of stroke diagnosis criteria and the effects of stroke on the brain that lead to cognitive impairment and end with memory loss. This article focuses on the role of available neuropsychological assessments in detection of dementia and memory loss after stroke. Numerous neuropsychological assessments are being used to evaluate and differentiate cognitive impairment and dementia following stroke. Currently, efforts are being exerted to assess stroke effects on the brain, particularly in the early stages. Stroke patients have a high potential to develop dementia within the first year of stroke onset. Cognitive impairment and memory dysfunction following stroke diagnosis are common symptoms that significantly affect the survivors' quality of life.
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