Why is this research needed?
Stroke survivors often experience cognitive problems, such as jumbled thoughts and difficulties remembering, but also changes in concentration, paying attention and seeing all around.
There are tests that can spot if a stroke survivor is experiencing problems, but we don’t know how the results of these tests relate to difficulties for stroke survivors in daily life. This means it’s difficult for stroke survivors, and those caring for them to get treatment for, and cope with, cognitive problems.
Most tests for cognitive problems were developed for dementia, not a stroke, and focus on memory. But stroke can also affect someone’s ability to speak or see properly. This means it can be unclear if results are due to memory problems, or something else, so we need better tests for cognitive problems after stroke which are made for this group specifically.
What is this research aiming to do?
This research can improve care for stroke survivors with cognitive problems by better understanding tests for these problems, how they affect day-to-day life, and how the problems may change over time.
Associate Professor Nele Demeyere and her team of researchers will find out:
- How tests that look at cognitive problems can relate to tests for other problems stroke survivors experience, and how this affects their everyday life.
Occupational therapists and physiotherapists at the John Radcliffe Oxford University hospital acute stroke unit will be consulted so the researchers can collect information about daily task functioning and link it to cognitive problems after stroke using the Oxford Cognitive Screen (OCS).
Other information that is regularly collected for stroke patients will be included. The researchers will analyse the unique collection of information to look at links between cognitive problems, other effects of their stroke and the patient, such as their age.
- How cognitive problems can change for stroke survivors over time, and if tests for cognitive problems done early in recovery can tell us about how stroke survivors may recover and adapt to life after stroke.
The researchers will add to the unique collection of information about stroke patients by looking more closely at the different aspects of cognitive problems.
They will contact people six months after their stroke and gather information to understand the longer-term effects of their stroke.
The researchers will then analyse the information to explore links between cognitive problems and other problems they may be experiencing after six months, and if early information about cognitive problems might indicate future recovery.
This award will support Nele to establish herself as a leader of stroke research, teaching and mentoring others to improve future research.
Nele led a cognitive screening programme collecting unique information about cognitive problems after stroke from over 900 stroke survivors at the John Radcliffe Oxford University acute stroke unit. This was linked to regularly collected information about other problems stroke survivors’ experience, and brain scans. Researchers are using this information to improve our understanding of how and why stroke survivors experience cognitive problems, and the effects of these problems on everyday life so better treatments can be discovered.
Nele and her team tested for cognitive problems after stroke using the newly created Oxford Cognitive Screen (OCS). The test can be used with stroke patients that have problems with reading, speaking and seeing, and is available in 13 languages. One hundred thousand stroke survivors are being screened with OSC every year, which can allow more people to get the support they need.
The researchers have developed an even more sensitive test that can help health care professionals understand more subtle and long term effects on stroke survivors who continue to experience thinking and memory problems. The new test, OCS-Plus, was launched in 2019 and is already starting to be used in research across the world.
Throughout her career, Nele has worked closely with stroke survivors, their carers and healthy older people to design, carry out and share the result of her research. She is recognised as the champion for patient and public involvement in the Department of Experimental Psychology at the University of Oxford.
She said: “Many stroke survivors have communication problems or very severe problems with their thinking, so it can be complicated to get their consent to take part. But for research to improve the lives of people affected by stroke, they need to be included in our studies. My team and I have taken to heart the importance of supporting everyone to take part in research.”
Nele’s research has helped revolutionise care for stroke survivors with cognitive problems after stroke. She’s also shared vital expertise by publishing over 33 papers, supporting eleven earlier career researchers, and attracting over £1million vital research funds to this area of great need in these 5 years.
Jacki, a stroke survivor said “It feels that finally, somebody is interested in the cognitive effects of stroke. This area of rehabilitation is often overlooked. But it’s the most important part of recovery and without being addressed can cost a person their livelihood.”
Nele received the Stroke Association Lord Leonard and Lady Estelle Wolfson Foundation Lectureship Award.