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Oxford Cognitive Screen

Oxford Cognitive Screen: A stroke-specific tool to assess post-stroke cognitive problems

For a long time, treatment for people affected by stroke has focussed on obvious changes like arm or leg strength and speech. However, more hidden effects of the stroke can have a major impact on people’s life once back home.  Indeed, the psychological consequences of stroke are some of the most disabling. Whilst stroke is an acute medical emergency, it is also a long-term condition. Instead of being the same as before a stroke, people must adjust to a new life which often includes changes in cognitive abilities. People living with stroke consistently report managing of mood and cognitive changes as their greatest challenge.

Immediately following a stroke almost everyone experiences cognitive impairments. These may include difficulties with understanding, reading, writing, remembering, spatial awareness and planning activities.  Failure to detect these changes can have a significant impact on post-stroke recovery. Cognitive screening is vital to facilitate rehabilitation, ensure appropriate support and enhance the quality of life of stroke survivors.

Until recently, the brief tools used for assessing post stroke cognitive problems were ‘borrowed’ from other conditions such as Alzheimer’s disease. Under the leadership of Professor Nele Demeyere, researchers at the University of Oxford developed The Oxford Cognitive Screen (OCS). The OCS was the first pragmatic bed-side tool providing a short, neuropsychology based cognitive assessment, in line with NICE guidelines on domain specific screening. This first-line, stroke-specific cognitive screen – following rigorous neuropsychological and psychometric approaches – assesses different cognitive domains relevant to stroke, including attention, praxis, memory, number and language. It was designed for use in time and resource-pressured acute clinical settings.

The OCS cognitive profiles highlight both strengths (preserved abilities) as well as difficulties in an at-a-glance cognitive snapshot. This profile contributes to multi-disciplinary team decisions on treatment plans and post-care discharge. Health service staff have benefitted from an easy-to-use tool allowing emphasis on both patient strengths and weaknesses in cognitive domains, monitoring progress, and improving communication around cognitive areas with patients, carers and other health professionals.


Professor Demeyere and her team have also recently developed OCS-Plus (2022), a computerised tablet- based tool developed to detect more subtle cognitive changes which may otherwise go undetected. The OCS-Plus primarily focusses on briefly assessing domain general performance in Memory and Executive Function. The OCS-plus has been validated and normed in a healthy ageing sample and is undergoing further research for validity of use in specific clinical groups.

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World map showing with a blue dot all the places where the OCS has been adopted.

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