Effects of low visual acuity on neuropsychological test scores:A simulation study

Objective: To systematically examine the effect of low visual acuity (LVA) on a number of commonly used neuropsychological tests. Method: In this study, the influence of LVA on a number of commonly used neuropsychological tests was examined in 238 healthy older adults (aged 50–80) without visual or neurological impairment. LVA was simulated using simulation glasses. Results: It was found that a simulated LVA of ∼0.2 (decimal acuity; Snellen 6/30 or 20/100, LogMAR 0.7) had a negative impact on test performance for the Trail Making Test, Complex Figure of Rey (copy score), and Visual Object and Space Perception battery subtest 3, but not for the Mini Mental State Examination and Balloons test. For some tests, the negative impact of LVA increased with age. Conclusions: These results have important implications for the use of neuropsychological tests in the visually impaired population. More specifically, when administering the Trail Making Test, Complex Figure of Rey (copy score), and Visual Object and Space Perception Battery subtest 3 to older people with LVA, low test scores should be interpreted with great caution. Low test scores on the Mini Mental State Examination and Balloons Test are not likely to be caused by LVA and are more likely to reflect actual cognitive impairment. The results contribute to the validity of neuropsychological assessment of older people with visual impairment, leading to more effective and more patient-based rehabilitation

Car Driving Performance in Hemianopia:An On-Road Driving Study

PURPOSE. To study driving performance in people with homonymous hemianopia (HH) assessed in the official on-road test of practical fitness to drive by the Dutch driver's licensing authority (CBR).METHODS. Data were collected from a cohort (January 2010-July 2012) of all people with HH following the official relicensure trajectory at Royal Dutch Visio and the CBR in the Netherlands. Driving performance during the official on-road tests of practical fitness to drive was scored by professional experts on practical fitness to drive, using the visual impairments protocol and a standardized scoring of visual, tactical and operational aspects. Age ranged from 27 to 72 years (mean = 52, SD = 11.7) and time since onset of the visual field defect ranged from 6 to 41 months (mean = 15, SD = 7.5).RESULTS. Fourteen (54%) participants were judged as fit to drive. Besides poor visual scanning during driving, specific tactical, and operational weaknesses were observed in people with HH that were evaluated as unfit to drive. Results suggest that judgement on practical fitness to drive cannot be based on solely the visual field size. Visual scanning and operational handling of the car were found to be more impaired with longer time not driven, while such an effect was not found for tactical choices during driving.CONCLUSIONS. Training programs aimed at improving practical fitness to drive in people with HH should focus on improving both visual scanning, as well as driving aspects such as steering stability, speed adaptation, and anticipating environmental changes.</p

The Screening Visual Complaints questionnaire (SVCq) in people with Parkinson's disease-Confirmatory factor analysis and advice for its use in clinical practice

Background: The Screening Visual Complaints questionnaire (SVCq) is a short questionnaire to screen for visual complaints in people with Parkinson's disease (PD). Objective: The current study aims to investigate the factor structure of the SVCq to increase the usability of this measure in clinical practice and facilitate the interpretation of visual complaints in people with PD. Methods: We performed a confirmatory factor analysis using the 19 items of the SVCq of 581 people with PD, investigating the fit of three models previously found in a community sample: a one-factor model including all items, and models where items are distributed across either three or five factors. The clinical value of derived subscales was explored by comparing scores with age-matched controls (N = 583), and by investigating relationships to demographic and disease related characteristics. Results: All three models showed a good fit in people with PD, with the five-factor model outperforming the three-factor and one-factor model. Five factors were distinguished: 'Diminished visual perception-Function related' (5 items), 'Diminished visual perception-Luminance related' (3 items), 'Diminished visual perception-Task related' (3 items), 'Altered visual perception' (6 items), and 'Ocular discomfort' (2 items). On each subscale, people with PD reported more complaints than controls, even when there was no ophthalmological condition present. Furthermore, subscales were sensitive to relevant clinical characteristics, like age, disease duration, severity, and medication use. Conclusions: The five-factor model showed a good fit in people with PD and has clinical relevance. Each subscale provides a solid basis for individualized visual care

Self-Reported Visual Complaints in People with Parkinson's Disease:A Systematic Review

BACKGROUND: Scientific research increasingly focuses on visual symptoms of people with Parkinson's disease (PD). However, this mostly involves functional measures, whereas self-reported data are equally important for guiding clinical care. OBJECTIVE: This review sprovides an overview of the nature and prevalence of self-reported visual complaints by people with PD, compared to healthy controls. METHODS: A systematic literature search was performed. Studies from three databases (PubMed, PsycInfo, and Web of Science) were screened for eligibility. Only studies that reported results of visual self-reports in people with idiopathic PD were included. RESULTS: One hundred and thirty-nine eligible articles were analyzed. Visual complaints ranged from function-related complaints (e.g., blurred vision, double vision, increased sensitivity to light or changes in contrast sensitivity) to activity-related complaints (e.g., difficulty reading, reaching, or driving). Visual complaints were more prevalent in people with PD compared to healthy controls. The presence of visual complaints leads to a reduced quality of life (QoL). Increased prevalence and severity of visual complaints in people with PD are related to longer disease duration, higher disease severity, and off-state. CONCLUSION: A large proportion of people with PD have visual complaints, which negatively affect QoL. Complaints are diverse in nature, and specific and active questioning by clinicians is advised to foster timely recognition, acknowledgement, and management of these complaints

Confirmatory factor analysis of the Dutch Screening Visual Complaints questionnaire in people with multiple sclerosis

BACKGROUND: Visual complaints among people with multiple sclerosis (pwMS) are common, but often difficult to recognize. The Screening Visual Complaints questionnaire (SVCq) has been developed to screen for visual complaints in people with a neurodegenerative disease, including multiple sclerosis (MS). A previous study performed a factor analysis in a normal population which revealed an acceptable one-factor model, a three-factor model and a five-factor model within the SVCq. To increase the usability of the SVCq in people with MS, the purpose of the current study was to investigate the fit of the three models in a cohort of pwMS. RESULTS: The confirmatory factor analysis on the SVCq in 493 people with MS showed good fit for all the models. The three-factor model (diminished visual perception, altered visual perception and ocular discomfort) outperformed the one-factor model. The five-factor model outperformed both models, which showed that dividing the first factor (diminished visual perception) into three more factors (function-related, luminance-related and task-related) has merit. CONCLUSIONS: All models may be useful in clinical care for pwMS. The one-factor model may give a quick overview of the presence and severity of visual complaints in general. The individual factors, of either the three- or the five factor models, may contribute to a better recognition of the nature of visual complaints in pwMS and may guide further steps in rehabilitation for pwMS with visual complaints

Neuropsychologische diagnostiek bij een lage gezichtsscherpte

De meeste neuropsychologische tests corrigeren waar nodig voor leeftijd, geslacht en opleiding. Er wordt echter geen rekening gehouden met de mogelijke invloed van slechtziendheid, terwijl veel ouderen slechtziend zijn. Omdat niet bekend is in hoeverre mensen met bepaalde visuele problematiek moeite hebben het testmateriaal goed waar te nemen, zijn lage testscores bij deze groep moeilijk te interpreteren. Daarmee is de validiteit van neuropsychologische diagnostiek bij met name de oudere populatie in het geding, zeker omdat zoveel tests visueel aangeboden worden. In dit artikel worden de resultaten samengevat van een wetenschappelijk onderzoek naar de invloed van lage gezichtsscherpte op neuropsychologische tests bij mensen in de leeftijd van 50 tot 80 jaar. Daarbij wordt besproken wat de implicaties van deze bevindingen zijn voor de klinische praktijk. Concreet worden aanbevelingen gegeven voor het afnemen en interpreteren van neuropsychologische tests bij mensen met een lage gezichtsscherpte

Spontaneous recovery and treatment effects in patients with homonymous visual field defects:A meta-analysis of existing literature in terms of the ICF framework

Homonymous visual field defects (HVFDs) are a common consequence of posterior brain injury. Most patients do not recover spontaneously and require rehabiliation. To determine whether a certain intervention may help an individual patient, it is necessary to predict the patient's level of functioning and the effect of specific training. We provide an overview of both the existing literature on HVFDs in terms of the International Classification of Functioning, Disability, and Health (ICF) components and the variables predicting the functioning of HVFD patients or the effect of treatment. We systematically analyzed 221 publications on HVFD. All variables included in these articles were classified according to the ICF, as developed by the World Health Organization, and checked for their predictive value. We found that ICF helps to clarify the scope of the existing literature and provides a framework for designing future studies, which should consider including more outcome measures related to Activities and Participation. Although several factors have been described that predict HVFD patients' level of functioning or the effects of training, additional research is necessary to identify more. (C) 2014 Elsevier Inc. All rights reserved

Correction:The Screening Visual Complaints questionnaire (SVCq) in people with Parkinson's disease-Confirmatory factor analysis and advice for its use in clinical practice (PLoS ONE 17: 9 (e0272559) DOI: 10.1371/journal.pone.0272559)

The Data Availability Statement for this article [1] is updated to: The data that support the findings of this study are available from DataVerseNL. Because of ethical reasons, restrictions apply to the availability of these data (i.e., the combination of variables can potentially lead to participants being identified). Data are available at https://doi.org/ 10.34894/V9IGKJ with the permission of the ethics board of the Faculty of Behavioral and Social Sciences, University of Groningen (contact: [email protected]).</p