Objective:

To survey the frequency of cognitive screening in neurologists and non-neurologists

Background:

Post-stroke cognitive impairment (PSCI) is common (up to 80%) and negatively impacts patients and their caregivers, although it is frequently underdiagnosed. Its appearance is related to demographic and vascular risk factors. Different specialties treat cerebrovascular disease (CVD), so we aimed to survey the frequency of cognitive screening in neurologists and non-neurologists. 

Design/Methods:

We made an electronic form (Google Forms) of 16 in-hospital and out-of-hospital cognitive screening questions for stroke patients (infarction, intracerebral and subarachnoid hemorrhage) that we sent through an instant messaging application (WhatsApp) popular in Latin America.

Results:

We got 61 responses from 7 countries. 46% of the physicians surveyed were non-neurologists. In-hospital cognitive screening in patients with cerebral infarction was similar between neurologists and non-neurologists (37.5% vs. 37.9%, respectively). Out-of-hospital neurologists performed cognitive screening more frequently (78.1% vs. 55.1%). Neurologists performed cognitive screening more frequently in patients with intracerebral and subarachnoid hemorrhages (65.6% vs 41.3%). The most used test was the MoCA test. The main reasons for not performing cognitive screening were time and physical limitations (aphasia, dysarthria, and intubation).

Conclusions:

In-hospital screening was only performed in 1/3 of the patients by neurologists and non-neurologists. However, out-of-hospital screening was higher by neurologists. This may delay the detection of PSCI in patients without access to a neurologist. PSCI significantly affects patients, caregivers, and quality of life but is not routinely evaluated in the inpatient or outpatient setting. Due to its high prevalence, it is necessary to encourage its assessment by both the neurologist and the non-neurologist. This will allow it to be identified and treated early.