ABSTRACT NUMBER: ESOC2026A740 RIGHT HEMISPHERIC STROKE SYNDROMES AND IMPLICATIONS FOR MENTAL CAPACITY ASSESSMENT: ALIGNMENT WITH THE UK MENTAL CAPACITY ACT 2005

Abstract Background and aims In stroke [ractice capacity assessments often prioritise language impairment, potentially under-recognising deficits in patients with right hemispheric stroke (RHS. RHS is associated with non linguistic cognitive syndromes, including visuospatial neglect, anososognosia, exxecutive dysfunction and impaired social cognition which may compromised decision making despite preserved verbal abilities (2-4) Aim To examine how cognative how cognative syndroms associated with RHS intract with the functional criteria of MCA 2005 and to highlight implications for accurate and lawful mental capacity assessment in stroke patients. Methods Cross section review of clinical and neuropshycological literature examining RHS related cognitive deficit and their impact on decision making capacity, interpreted through the four stationary elements of MCA 2005(1. Results RHS selectively impairs the views or weighing component of mental capacity as defined by the MCA (1). Visuospatial neglect reduces situational awareness and integration of environmental information into decision (2). Anosognasia disdurbs insight and self evaluation, leading to over estimation of ability and unreliable self rapport (3,4). Executive dysfunction compromises planning cognitive flexibility and cosequence appraisal (5). while impaired socail cognition affects appreciation of interpersonal and contextual factors required for informed cosent (6). These deficit may not be detected by standard capacity assessments focused primarily on comprehension and recall. Conclusions Right hemispheric stroke poses a distinct challenge to mental capacity assessment under the MCA 2005. Predserved speech and memory do not guarantee preserved capacity, lawful and ethical assessment requires targeted evaluation of attention, insight , executive reasoning and social cognition supported by multidisciplinary and collateral information. Conflict of interest Dr Aktham Elrekaby . nothing to disclose Dr Mustafa Al-shahni . nothing to disclose Israa Ruabye. nothing to disclose