New tool to gauge mental health of stroke victims

NNI develops score sheet to get better sense of who is at risk and carry out early intervention

Dementia-like symptoms which hit many stroke victims often go ignored, resulting in some of them finding themselves struggling to function at work months later.

Doctors at the National Neuroscience Institute (NNI) - the main centre here studying diseases that affect the brain - have always found it difficult to predict who would be afflicted by this problem.

Now a team at NNI, headed by Associate Professor Nagaendran Kandiah, has developed a score sheet that provides a better sense of who might be at risk, allowing early intervention.

Around 7,000 people in Singapore suffer a stroke each year. And about 40 per cent eventually develop some sort of cognitive impairment within a year.

The focus has traditionally been on recovering from post-stroke physical impairment, said Prof Nagaendran, who is from NNI's neurology department. "Very little attention has been given to the mental status, but a lot of patients and their caregivers suffer because of this mental impairment."

He recounted how a patient, identified only as Mr Tan, recovered from a mild stroke and went back to work as a mechanic after six weeks. "But at work he had problems, mixing up spare parts for vehicles; he had some complaints from clients and... what finally happened was that he lost his job," said Prof Nagaendran.

With the new score sheet, doctors can pick up patients like Mr Tan earlier and send them for special cognitive rehabilitation programmes or prescribe memory-enhancing drugs.

The score sheet looks at indicators such as a person's age, level of education, stroke history and degree of brain shrinkage after the stroke. It has been tested on nearly 400 people so far, with the results - which show that the score sheet is effective - published in an international journal earlier this year.

Although the score sheet is still undergoing further validation, the plan is to have it used routinely for all stroke patients at NNI.

"We are also looking at more specific cognitive training programmes targeting post-stroke patients," said advanced practice nurse Esther Chen, explaining that the current ones are more general.

NNI hopes to roll out those programmes by the first quarter of next year.

Prof Nagaendran said: "If you manage patients with post-stroke cognitive impairment properly, there's a good proportion who can go back to a good, reasonable quality of life."

A version of this article appeared in the print edition of The Straits Times on November 11, 2016, with the headline 'New tool to gauge mental health of stroke victims'. Print Edition | Subscribe