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Visual neglect and cognitive impairment in elderly patients late after stroke.

Linden T, Samuelsson H, Skoog I, Blomstrand C

The Stroke Research Unit, Arvid Carlsson Institute, Institute of Clinical Neuroscience, Gothenburg University, Gothenburg, Sweden. tlinden@neuro.gu.se

OBJECTIVES: To investigate the prevalence of visual neglect and its relationship to cognitive impairment and dementia in elderly stroke patients 20 months after stroke. METHODS: Of 243 stroke patients aged 70-91 years, 149 underwent neuropsychiatric testing, 138 with the Star Cancellation Test for visual neglect. RESULTS: Fifteen per cent (n = 21) had visual neglect, 9% (n = 12) severe and 9% (n = 12) lateralized. Cognitive impairments were twice as common in patients with neglect as in patients without it and threefold more common when the neglect was severe. Neglect was related to apraxia, impaired visual field, and a previous stroke. Severe neglect was related to dementia, amnesia and impaired visual field. CONCLUSIONS: Chronic neglect is common after stroke in elderly patients. So are cognitive impairments, especially in those with neglect. This calls for high alertness to impairments in spatial attention when treating patients with dementia and other cognitive impairments.

Published 4 February 2005 in Acta Neurol Scand, 111(3): 163-8.
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