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Determinants of Living Well With Aphasia in the First Year Poststroke: A Prospective Cohort Study

      Abstract

      Objective

      To determine factors that contribute to living well with aphasia in the first 12 months poststroke.

      Design

      Prospective longitudinal cohort study.

      Setting

      Hospitalized care, ambulatory care, and general community.

      Participants

      A referred sample of people (N=58) with a first incidence of aphasia after stroke was assessed at 3, 6, 9, and 12 months postonset. Participants were recruited through speech-language pathologists in 2 capital cities in Australia. Presence of aphasia was determined through the Western Aphasia Battery-Revised by an experienced speech-language pathologist.

      Interventions

      Not applicable.

      Main Outcome Measures

      The main outcomes were the 5 domains of the Assessment for Living with Aphasia at 3, 6, 9, and 12 months poststroke. The independent variables included demographics, physical functioning, social network, mood, aphasia severity, and a self-rating of successfully living with aphasia at the same time points. Mixed effects modeling was used to determine which factors contributed to the trajectory of each of the 5 domains of participation, impairment, environment, personal factors, and life with aphasia.

      Results

      Higher household income, larger social network size, being a woman, and having milder aphasia were positively associated with the participation domain. Graduate or postgraduate educational levels, low mood, and poor physical functioning were negatively associated with the participation domain. Factors positively associated with other domains included higher income, self-ratings of successfully living with aphasia, and aphasia severity. Low mood was consistently negatively associated with all of the domains.

      Conclusions

      Psychosocial determinants were the most significant predictors of living well with aphasia in the first 12 months postonset. Aphasia rehabilitation needs to attend more to these factors to optimize outcomes.

      Keywords

      List of abbreviations:

      ALA (Assessment for Living with Aphasia)
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