Prevalence, Severity and Impact of Visuospatial Neglect in Geriatric Stroke Rehabilitation, a Cross-Sectional Study

Martine S Bosma; Monique A A Caljouw; Wilco P Achterberg; Tanja C W Nijboer

doi:10.1016/j.jamda.2023.06.038

Prevalence, Severity and Impact of Visuospatial Neglect in Geriatric Stroke Rehabilitation, a Cross-Sectional Study

J Am Med Dir Assoc. 2023 Nov;24(11):1798-1805. doi: 10.1016/j.jamda.2023.06.038. Epub 2023 Aug 24.

Authors

Martine S Bosma¹, Monique A A Caljouw², Wilco P Achterberg², Tanja C W Nijboer³

Affiliations

¹ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; Zorggroep Florence, Rijswijk, the Netherlands; University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: M.Kant-Bosma@LUMC.nl.
² Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands.
³ Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands.

PMID: 37634546
DOI: 10.1016/j.jamda.2023.06.038

Abstract

Objectives: Visuospatial neglect (VSN) is a common cognitive deficit of lateralized attention after stroke and can have a negative influence on patients' daily activities, community participation, and caregiver burden. VSN prevalence has been investigated in several mixed-age populations, but rarely in only an older population. As the population in geriatric rehabilitation (GR) is understudied and VSN may influence rehabilitation goals in GR (return home), we examined the prevalence of VSN as well as associations between VSN (severity) and population characteristics and the impact of VSN on functioning, length of stay, and discharge destination after GR.

Design: Multicenter cross-sectional study.

Setting and participants: Stroke patients admitted to GR.

Methods: Three VSN tests (Star cancelation task, Line bisection task, and Catherine Bergego Scale) were administered in the first 2 weeks of GR admission. To examine VSN severity, a composite score was calculated based on scores of the 3 tests.

Results: A total of 114 stroke patients were included [55.3% female; mean age 80.2 (SD 8.0) years]. VSN prevalence was 47.4%, in which allocentric and egocentric neglect were more prevalent than VSN during activities of daily living. Participants with VSN spent more days in GR compared to participants without VSN (median 68.5 vs 35.5 days) and had fewer home returns. In addition, VSN participants showed less mobility, lower cognitive functioning, and less independence during self-care compared to participants without VSN. Mobility, self-care, cognition, duration of rehabilitation, and home return were negatively associated with VSN severity.

Conclusions and implications: VSN is very prevalent in the GR stroke population. VSN severely hampers older people during daily activities and their rehabilitation process and, therefore, has a major personal and societal impact. Accordingly, systematic assessment of VSN in the early phase of geriatric rehabilitation with multiple VSN screening tests is recommended.

Keywords: Geriatric rehabilitation; assessment; functional outcome; measurement; neglect; prevalence; severity; stroke.

Publication types

Multicenter Study

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Male
Prevalence
Stroke Rehabilitation*
Stroke* / complications