Nutritional assessment in stroke patients: from acute phase to chronicity

Stroke represents one of the leading causes of disability and mortality globally, with survivors facing significant physical, cognitive, and nutritional challenges. Nutritional management is critical to promote recovery and enhance functional and clinical outcomes of patients. Nutritional screening is essential to optimize intervention strategies across all phases of the disease, from the acute phase focusing on stabilization and prevention of immediate complications, to the chronic phase requiring long-term approaches to address malnutrition and dysphagia. Consequently, stroke presents considerable nutritional difficulties, including a high prevalence of dysphagia, complicating meal administration and leading to protein-energy malnutrition. Nutritional assessment must be tailored to the clinical characteristics of stroke patients and adaptable across different disease phases and care settings. Currently, various guidelines and studies have addressed nutritional assessment in stroke patients, primarily focusing on the acute phase and lacking specific tools for different disease stages. Moreover, in the chronic phase of the disease, the involvement of family members and caregivers is crucial in nutritional management, providing emotional support and improving patient adherence to nutritional interventions. In this context, ethical care extends beyond medical treatment, encompassing a holistic approach that considers the patient's emotional, psychological, and relational needs, integrating patient and family preferences, as well as cultural practices.