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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 22, 2016
Footnotes
Supported by the National Health and Medical Research Council in Australia (grant no. 631464).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
