Abstract
BACKGROUND: Post-stroke cognitive impairment (PSCI) remains under-recognized in Sub-Saharan Africa (SSA), in part due to the lack of validated cognitive screening tools adapted to low-literacy populations. We aimed to validate the Identification of Dementia in Elderly Africans (IDEA) cognitive screen in SSA and assess its utility for detecting PSCI in Guinea and Cameroon. METHODS: Normative IDEA scores were derived from a control cohort of healthy older adults in Conakry (Guinea) and Bafoussam (Cameroon). The tool was then applied to consecutive stroke patients from the same hospitals within one month of stroke onset. Demographic, clinical, and vascular risk profiles were collected. Between-group comparisons were performed using Welch's t-tests and chi-square tests. RESULTS: Among 91 healthy controls (median age: 64), the mean IDEA score was 12 ± 2.4. A cut-off of ≤7 (2 standard deviations below the mean) was defined for cognitive impairment. Among 111 stroke patients (median age: 65; mean NIHSS: 9.9 ± 5.8), the mean IDEA score was 9.6 ± 3.2, and 31 patients (28%) had scores ≤ 7. Stroke patients had significantly higher rates of hypertension and diabetes compared to controls. CONCLUSIONS: The IDEA screen appears to be a feasible and effective tool for detecting PSCI in SSA clinical settings. The 28% prevalence of cognitive impairment aligns with data from high-income countries, supporting the broader use of the IDEA to strengthen cognitive care pathways in SSA stroke populations.