Visuoperceptual deficits and participation in older adults after stroke

Abstract

Visuoperceptual deficits frequently occur after a stroke, but little is known about how they evolve over time. These deficits may have an impact on participation in daily activities and social roles. The aims were to (i) track changes over six months in the visual perception of older adults with persistent visuoperceptual deficits after a stroke; (ii) examine if these changes differed between participants who had and had not received rehabilitation services; and (iii) verify if participation differed between participants with and without visuoperceptual deficits. Visual perception as well as participation of 189 older adults who had had a stroke were evaluated in the first month (T1) after being discharged home from an acute care hospital (NO REHAB group) or rehabilitation unit (REHAB group). For visual perception, only participants presenting deficits at T1 were re-evaluated at three months (T2; n = 93), and those with deficits at T2 were re-evaluated at six months (T3; n = 61). A total of 57 people (30.2%) had visuoperceptual deficits six months after discharge home. Despite persistent deficits, approximately 45% of the participants in the two groups improved whereas 50% of the NO REHAB group and 24.3% of the REHAB group deteriorated. Changes in the mean scores on the MVPT-V were similar in the two groups. Participation, and especially participation in social roles, was more restricted in participants with visuoperceptual deficits (P < 0.001), independent of the severity of the stroke. Visuoperceptual deficits are common post-stroke. However, they evolve differently in different people and are associated with a reduction in participation.