Oxford Cognitive Screen - visual impairment adaptation

Brief Lay background

Problems with cognitive impairment which may include difficulties with memory, paying attention or recognising places or things, is common after a stroke. These difficulties can change the best way to manage other problems following stroke.

What problem/knowledge gap does it help address

The Oxford Cognitive Screen was made to be accessible to as many stroke survivors as possible. This included those that could not communicate by speaking, those that could not hold a pen to write and those that were unaware of one side.

However, the current version does not accommodate for people that are unable to see smaller sizes of text or detail, which is approximately 44% of stroke survivors. A study has shown that those with difficulty seeing smaller sizes of text have difficulty completing two of the ten tasks which make up the assessment.

The reason for this can be directly related to stroke, caused by problems with their eyes from before the stroke or because they do not have access to their reading glasses in hospital.  

Aim of the project

To adapt the Oxford Cognitive Screen to accommodate a test for reduced visual acuity, improving the accessibility of the test.

Key procedures/objectives

1. In line with normal practice, those admitted to hospital with a stroke will have their vision and cognition screened. Participants will complete both versions of the two adapted tasks, interspersed by the other eight tasks.
2. Test the new version of the screen tasks on 500 stroke survivors across a range of ages (18+) and cognitive abilities.

Potential impact on people with sight loss

The new version of the Oxford Cognitive Screen will replace the old one, allowing complete and accurate cognitive screening when stroke survivors have difficulty with seeing smaller sizes of text, which will better inform future care decisions that are appropriate to their needs.

This approach could also pave the way for other tests which are done using pen and paper to be adapted for those that have difficulty with seeing smaller sizes of text.