Prognosis for patients with neglect and anosognosia with special reference to cognitive impairment.
OBJECTIVE
To describe prognosis in patients with unilateral neglect, anosognosia, or both, within a community based stroke cohort.


METHODS
Patients (n = 377) were evaluated at baseline for the presence of neglect and anosognosia. After 1 year, the level of disability was established in survivors. Predictors for death and dependency were examined in multivariate analysis. The following independent variables were used: age, consciousness, hemianopia, arm paresis, leg paresis, sensory disturbance, aphasia, neglect, anosognosia, diabetes mellitus, cardiovascular disease, pre- and post-stroke cognitive impairment.


RESULTS
Age, consciousness and sensory disturbance predicted death. Post-stroke cognitive impairment, neglect, hemianopia, arm paresis and age predicted dependency.


CONCLUSIONS
Neglect in the acute phase, which occurs in patients irrespective of pre-stroke cognitive level, negatively affects disability after 1 year. Anosognosia more often occurs in patients who are cognitively impaired before the stroke. These patients often are ADL-dependent already, or become dependent because of cognitive impairment, not because of anosognosia.
Appelros
Peter
P
Department of Neurology, Orebro University Hospital, Orebro, Sweden. peter.appelros@orebroll.se
Karlsson
Gunnel M
GM
Seiger
Ake
A
Nydevik
Ingegerd
I
D000367:Age Factors; D001364:Awareness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D018450:Disease Progression; D006801:Humans; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D011379:Prognosis; D020127:Recovery of Function; D020521:Stroke / Q000150:complications* / Q000401:mortality / Q000523:psychology