Grant: Operating Grant

Stroke is the top cause of brain disorders in adults. Bad outcomes (like dying, having a heart attack, having another stroke or having to move to a long-term care facility) are very common after a stroke. We need better ways to find people at high risk, and we need to treat problems that increase these risks. Depression, Obstructive sleep apnea (OSA) and Cognitive impairment (DOC comorbidities) are all common after a stroke. All three cause poorer outcomes, less recovery and worse quality of life. They also increase the risk of having another stroke and the short-term risk of dying. We have created a simple, fast tool, called the DOC screen to assess patients for these problems. The tool can be used easily in busy stroke clinics and the results are as good as longer tests. We know that common factors such as old age or medical history (e.g. diabetes, heart disease) increase the chance of a bad outcome. No study has ever seen if screening for DOC conditions can help to identify people at high risk. This is the main goal of our study. We will screen, track risk factors and find out what happens to people at six Regional Stroke Prevention Clinics across Ontario. Our approach is unique and will address important gaps in the care of people with stroke. Quick screening can check all three conditions in large numbers of people, and help them get treatment for problems found. Their outcomes can be tracked inexpensively using Provincial records. The study will help more people to be screened according to Best Practice Recommendations, will provide tools to help treat problems found, will provide highly impactful information about long-term risks facing stroke survivors and will help to identify new approaches to prevent bad outcomes. Given the impact of bad outcomes after stroke, and given how common they are, this study will help improve the recovery, daily functioning and quality of life of thousands of Canadians every year.