Neglect and Anosognosia After First-Ever Stroke: Incidence and Relationship to Disability
Peter Appelros , Gunnel M. Karlsson , Åke Seiger , Ingegerd Nydevik
Neglect and anosognosia are serious consequences of stroke. Authors have found great variations in their incidence and their relationship to disability has been unclear. We studied the incidence of neglect and anosognosia within the scope of a population-based stroke-incidence study, and also evaluated their impact on disability. Four tests of visuo-spatial neglect, four tests of personal neglect, and an anosognosia questionnaire were used. Sixty-two patients (23%) of the study group had visuo-spatial neglect according to our definition, 21 patients (8%) had personal neglect, and 48 (17%) showed signs of anosognosia. Using a multiple logistic regression model, we found that both neglect and anosognosia influenced disability. To ascertain the true incidence of neglect and anosognosia after stroke, it is necessary to use a community-based study design, where cases treated outside the hospital are included. Some of the variability found in previous incidence studies is likely to be explained by not using such a design.