老年脑卒中康复中视空间忽略的患病率、严重程度和影响：一项横断面研究。

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

机构信息

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.

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.

出版信息

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

DOI:10.1016/j.jamda.2023.06.038

PMID:37634546

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.

摘要

目的

视觉空间忽略（VSN）是中风后侧化注意力的常见认知缺陷，会对患者的日常活动、社区参与和照顾者负担产生负面影响。VSN 的患病率已在多个混合年龄人群中进行了调查，但在仅老年人中很少研究。由于老年康复（GR）中的人群研究不足，并且 VSN 可能会影响 GR 中的康复目标（返回家中），因此我们检查了 VSN 的患病率，以及 VSN（严重程度）与人口特征之间的关联，以及 VSN 对功能、住院时间和 GR 出院去向的影响。

设计

多中心横断面研究。

地点和参与者

GR 住院的中风患者。

方法

在 GR 入院后的前 2 周内进行了 3 项 VSN 测试（星号取消任务、线二分任务和 Catherine Bergego 量表）。为了检查 VSN 严重程度，根据 3 项测试的分数计算了综合评分。

结果

共纳入 114 例中风患者[55.3%女性；平均年龄 80.2（8.0）岁]。VSN 的患病率为 47.4%，其中，在日常生活活动中，心像性和自我中心性忽视比 VSN 更常见。有 VSN 的参与者比没有 VSN 的参与者在 GR 中花费的天数更多（中位数 68.5 天 vs 35.5 天），并且回家的次数更少。此外，与没有 VSN 的参与者相比，有 VSN 的参与者在移动性、认知功能和自理方面的独立性较低。移动性、自理、认知、康复时间和回家与 VSN 严重程度呈负相关。