A new rapid cognitive screening tool developed by the University of Queensland (UQ) is helping people who have experienced a stroke by quickly detecting impairments that otherwise may have been missed.
Every day, around 112 people in Australia experience a stroke, with 23 dying as a result. Surviving a stroke is obviously good news, but a stroke can leave a person with a number of difficult mental and physical impairments.
During a stroke event, oxygen and important nutrients are cut off from the brain, usually due to a blood clot or sudden bleeding reducing blood supply.
This lack of oxygen can damage key parts of your brain responsible for speech, mental reasoning and core motor functions.
Common impairments after a stroke include impaired speech, restricted ability to walk and get up from chairs, weakness or paralysis in limbs on one side of the body, difficulty gripping or holding things and a slowed or slurred speech.
The severity of any impairments depends on how long the brain was starved of oxygen. Sometimes the damage is severe and quite obvious to an observer. Sometimes it is less severe, and the impairments more subtle and easy to miss.
Professor Gail Robinson, from UQ’s Queensland Brain Institute, says this can lead to poor recovery outcomes for recovering stroke patients once they leave hospital.
For example, impairments in propositional language and executive function skills affect every aspect of our lives. If a person looks and sounds like they did before the stroke, the people around them will naturally treat them the same, but internally they may be struggling to hold a conversation or understand questions.
“If these impairments aren’t identified in hospital, patients can return home and find relationships, managing daily tasks or returning to work a challenge,” she says.
“Once a person is home, they’re also less likely to seek help, even when these subtle or hidden impairments affect their quality of life.
Conventional testing in hospital for impairments following a stroke can take two to three hours and less time-consuming screening tests only detect severe impairments.
Enter BELS
Prof. Robinson and her team have developed the Brain Executive Language Screening (BELS) test that can be used by health professionals to assess a patient’s cognitive skills in minutes.
“BELS is a short, sensitive bedside test that only takes 20 to 30 minutes but is comprehensive and suitable for all stroke patients,” she says.
Based on 12 years of research, BELS tests memory, motor function for speech, core language, conversational speech and complex mental abilities needed for decision making.
“BELS picks up subtle impairments in conversational speech and complex mental abilities that can be impacted by stroke but are often overlooked in patients who do not have obvious language problems that affect their ability to speak,” says Prof. Robinson.
The UQ research team recently demonstrated the BELS test’s effectiveness in a study published in the journal Topics in Stroke Rehabilitation.
In the study, the UQ team studied 88 stroke patients within seven weeks of their stroke, comparing their test results with 116 age-matched healthy individuals. The stroke patients were all found to have slight impairments in key areas of language compared with the control group.
“By using the BELS test to detect impairments early in an acute setting, health professionals can tailor the person’s rehabilitation plan to address those challenges effectively,” says Prof. Robinson.
The UQ team is now developing a BELS test to assess the cognitive skills of people with dementia and brain tumours.
Have you or anyone you know experienced a stroke? Could a test like BELS have been helpful for you? Let us know in the comments section below.
Also read: Five health conditions that can mimic stroke symptoms
