# The need for post-stroke cognitive screening - the rationale behind the Hungarian adaptation of the Oxford Cognitive Screen (OCS) and its pilot study

## TL;DR

This paper introduces a Hungarian version of the Oxford Cognitive Screen to detect cognitive issues after stroke, aiming to improve patient care and outcomes.

## Contribution

The first Hungarian adaptation of a stroke-specific cognitive screening tool with cultural and linguistic validation.

## Key findings

- The Hungarian OCS was well-received by patients and clinicians during pilot testing.
- The tool identified a median of two impaired cognitive tasks in stroke patients.
- The adaptation process confirmed the feasibility and usability of the tool in a Hungarian context.

## Abstract

•First Hungarian adaptation of a stroke-specific neuropsychological screening tool, the Oxford Cognitive Screen.•Provides a culturally and linguistically validated, stroke-specific tool.•Pilot study confirmed feasibility and strong acceptance by patients and clinicians.•Fills a critical gap in stroke care by facilitating cognitive screening in Hungary.•Supports earlier detection of PSCI, guiding rehabilitation and improving outcomes.

First Hungarian adaptation of a stroke-specific neuropsychological screening tool, the Oxford Cognitive Screen.

Provides a culturally and linguistically validated, stroke-specific tool.

Pilot study confirmed feasibility and strong acceptance by patients and clinicians.

Fills a critical gap in stroke care by facilitating cognitive screening in Hungary.

Supports earlier detection of PSCI, guiding rehabilitation and improving outcomes.

Post-stroke cognitive impairment (PSCI) is a frequent yet underdiagnosed consequence of stroke, with significant implications for quality of life, functional outcomes and long-term prognosis. Despite its importance, cognitive screening remains insufficiently integrated into post-stroke care protocols, particularly in Hungary.

This study aimed to adapt and pilot the Oxford Cognitive Screen (OCS) for Hungarian stroke patients, addressing the urgent need for a culturally and linguistically appropriate, stroke-specific cognitive screening tool that is freely available in Hungarian.

The Hungarian adaptation followed a rigorous 11-step linguistic validation process, including cultural adaptation, forward and back translations, reviews, and pilot testing. Ten stroke patients at Semmelweis University were assessed using the adapted OCS within three weeks of symptom onset. Data on test performance, feasibility, and patient feedback were collected from 10 pilot patients and 6 examiners.

The adaptation and pilot testing process, completed in approximately three months, confirmed the usability of the tool, with most patients finding it engaging. The median number of impaired tasks was two. No major issues arose, and the tool was well received by both patients and examiners.

The Hungarian version of the OCS offers a practical, user-friendly cognitive screening tool tailored for stroke patients. Its implementation could enhance early detection of PSCI, improve patient safety by supporting targeted rehabilitation, and ultimately contribute to better long-term outcomes. This initiative represents a foundational step toward integrating cognitive screening into stroke protocols in Hungary, addressing a significant gap in rehabilitation and healthcare equity.