Abstract TP91: Baseline Comorbidities and Functional Status Are Associated With Subacute Post-Stroke Aphasia Severity

Abstract

Speech or language changes are just one of the critical stroke warning signs. While symptoms may resolve with treatment, there are individuals for whom aphasia persists. The purpose of this study was to develop a better understanding of which factors are associated with aphasia status in the first six months after left hemisphere stroke to aid clinicians in discussing prognosis and preparing patients for what to expect in recovery. The sample consisted of a subset of individuals from a large, ongoing, federally funded, observational study of speech and language profiles, for whom an NIH Stroke Scale (NIHSS) total score was available (N=59, 35 female, mean age at stroke= 65 years, range = 38-92). We analyzed the complex interaction between the baseline medical (reperfusion/surgical intervention; comorbid hypertension, atrial fibrillation, high cholesterol, diabetes), functional (NIHSS total score), and demographic (age, sex, race) characteristics associated with the Quick Aphasia Battery (QAB) overall score, a measure of aphasia severity, using multiple linear regression. An additional one-way ANOVA was conducted to examine the relationship between baseline (NIHSS language subtest rating) and subacute aphasia status. The multiple linear model of the relationship between baseline factors and subacute aphasia severity was significant (F(114, 43)=1.956, p=0.047), though it accounted for less than 40% of the variance in aphasia severity scores. Of the factors included in the model, hypertension (F(1, 43)=4.513, p=0.039) and NIHSS total score (F(1, 43), p<0.001) were significant. In our secondary analysis, the one-way ANOVA was significant (F(3, 50)=6.106, p=0.001) with individuals rated as normal having, on average, a 3 point difference (p=.001) in overall QAB score from those rated as mute at baseline. This study examined the association between baseline comorbidities and functional status in adults with subacute post-stroke aphasia. We noted that hypertension and baseline NIHSS total score are significantly related to aphasia severity as measured by the QAB overall score in the subacute phase. Although much variation exists, our results may indicate that those with unimpaired language at baseline tend to perform better later in recovery.