Aphasia As a Predictor of Stroke Outcome

Lazar, Ronald M.; Boehme, Amelia K

doi:10.1007/s11910-017-0797-z

Cited by 76 publications

(49 citation statements)

References 29 publications

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“…Similarly, stroke severity, measured by National Institute of Health Stroke Scale, is also another important rehabilitation outcome predictor [ 49 – 51 ]. Furthermore, a recent review by Lazar et al revealed that aphasia arising from stroke was associated with worse outcomes in both the acute and chronic stroke periods with poorer functional recovery and increased length of rehabilitation and mortality risk [ 52 ].…”

Section: Predictors Of Good Rehabilitation Outcome In Elderly Stromentioning

confidence: 99%

Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges

Lui

Nguyen

2018

Current Gerontology and Geriatrics Research

125

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There have been many advances in management of cerebrovascular diseases. However, stroke is still one of the leading causes of disabilities and mortality worldwide with significant socioeconomic burden. This review summarizes the consequences of stroke in the elderly, predictors of stroke rehabilitation outcomes, role of rehabilitation in neuronal recovery, importance of stroke rehabilitation units, and types of rehabilitation resources and services available in Singapore. We also present the challenges faced by the elderly stroke survivors in the local setting and propose strategies to overcome the barriers to rehabilitation in this aging population.

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Section: Predictors Of Good Rehabilitation Outcome In Elderly Stromentioning

confidence: 99%

Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges

Lui

Nguyen

2018

Current Gerontology and Geriatrics Research

125

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“…These groups were included separately (see Table 1 and Fig 2). I excluded 11 reviews [6,9,10,[46][47][48][49][50][51][52][53], 34 studies with insufficient information about the sexes [2,, 6 studies with insufficient aphasia information [87][88][89][90][91][92], 14 studies with insufficiently specified sampling procedure for aphasia patients from stroke cohorts [93][94][95][96][97][98][99][100][101][102][103][104][105][106], and one study with repetition of data use [38] (see Fig 1). Fig 1.…”

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confidence: 99%

Sex differences in post-stroke aphasia rates are caused by age. A meta-analysis and database query

Wallentin

2018

Preprint

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Background: Studies have suggested that aphasia rates are different in men and women following stroke. One hypothesis says that men have more lateralized language function than women. Given unilateral stroke, this would lead to a prediction of men having higher aphasia rates than women. Another line of observations suggest that women are more severely affected by stroke, which could lead to a higher aphasia rate among women. An additional potential confounding variable could be age, given that women are typically older at the time of stroke. Methods & Procedures:This study consists of two parts. First, a meta-analysis of the available reports of aphasia rates in the two sexes was conducted. A comprehensive literature search yielded 25 studies with sufficient information about both aphasia and gender. These studies included a total of 48,362 stroke patients for which aphasia rates were calculated.Second, data were extracted from an American health database (with 1,967,038 stroke patients), in order to include age and stroke severity into a regression analysis of sex differences in aphasia rates.Outcomes & Results: Both analyses revealed significantly larger aphasia rates in women than in men (1.1-1.14 ratio). This speaks against the idea that men should be more lateralized in their language function. When age and stroke severity were included as covariates, sex failed to explain any aphasia rate sex difference above and beyond that which is explained by age differences at time of stroke.A stroke is a medical condition in which blood flow to the brain is restricted, due to occlusion (ischemic stroke) or hemorrhage (hemorrhagic stroke), resulting in cell death (WHO). In the US alone, approximately 800,000 people experience a stroke every year, according to the American Heart Association [1]. Stroke is the leading cause of motor and cognitive disability in western countries and aphasia, the inability to comprehend and formulate language because of brain damage, is one of the most common deficits after stroke. A large variability in the reported frequency of aphasia can be found in the literature [e.g. 2, 3-5], ranging from 15 % to 68 % of acute patients. A recent meta-analysis, however, concluded that aphasia is present in approximately 30 % of acute patients and 34 % in rehabilitation settings [6]. Variability of measured rate of aphasia has many causes. The method for aphasia identification differs between hospitals and countries and some sub-scores for aphasia in stroke scales have been found to be limited in their accuracy and reliability [7,8]. Another potential source of variance may be sex. The above-mentioned meta-analysis did not take potential sex differences into account.Stroke has been noted to affect the sexes differently. Stroke has been reported to be more common among men [9]. The symptoms of stroke have also been found to differ somewhat between men and women. Women are often more severely affected overall, more often experience paralysis, impaired consciousness and altered mental status together wit...

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“…The MDS-ABI was developed for use with every person with ABI, but appeared unsuitable for a proportion of the target group due to communicative or cognitive limitations. Oftentimes, patients who experience these limitations are excluded from assessments in the context of scientific research or health care, when in fact, these patients are most prone to more severe long-term consequences of brain injury [43][44][45][46][47][48], leading to bias in research [49]. In order to be able to capture core data on the full spectrum of persons with ABI, we now developed a proxy-rated version of the self-reported part of the MDS-ABI (part B), which can be completed by someone who is close to the patient.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a minimal dataset for adults with acquired brain injury in Dutch healthcare practice

et al. 2020

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Objective Data collection in the field of acquired brain injury (ABI) lacks uniformity due to the broad spectrum of available measurement instruments, leading to incomparability of data and the need for patients to 'repeat their story'. To pursue uniform data collection, an ABI-specific minimal dataset (MDS-ABI) is currently under development. The current study aimed to assess the feasibility (performance according to protocol, user opinion, potential implementation barriers, and suggested improvements) of the MDS-ABI in clinical settings. Methods A mixed-methods approach was used in a range of healthcare sectors for persons with ABI. Clinicians of several relevant disciplines within these sectors were asked to administer the MDS-ABI to five patients. Subsequently, feasibility according to clinicians was assessed by means of a paper questionnaire about every administration and an online questionnaire about the feasibility in general. Feasibility according to patients was assessed with a paper questionnaire and think aloud interviews. Results Thirteen clinicians and 50 patients were included. In general, the MDS-ABI performed according to protocol. Both clinicians and patients were overall satisfied with the content of the MDS-ABI. The Cumulative Illness Rating Scale was regarded incomprehensible, leading to missing data. Further, clinicians indicated that the MDS-ABI would not be suitable for all ABI-patients, as some are incapable of self-report due to potential cognitive problems, communicative problems, fatigue, perceptual problems, or impaired awareness of deficits.

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Aphasia As a Predictor of Stroke Outcome

Cited by 76 publications

References 29 publications

Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges

Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges

Sex differences in post-stroke aphasia rates are caused by age. A meta-analysis and database query

Feasibility of a minimal dataset for adults with acquired brain injury in Dutch healthcare practice

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