Abstract WP103: The Role of Social Determinants in Aphasia Outcomes

Abstract

Introduction: Aphasia is a post-stroke communication disorder that negatively impacts quality of life and life satisfaction even in its mildest form. Traditionally predictors of aphasia outcomes have emphasized neurological factors and little is known about the role that the social, cultural, environmental, and economic determinants of aphasia outcomes. Hypothesis: We hypothesize that non-neurological social factors (social determinants) are linked to post-stroke aphasia outcomes in a large, diverse population of individuals with aphasia. Methods: Merged data from the AphasiaBank—a large database designed to explore aphasia outcomes using data collected from aphasia studies based on standardized protocols were matched with data from the National Health Interview Survey (NHIS) based on range of sociodemographic and clinical outcomes to create an integrated dataset to examine the association between social determinants and aphasia outcomes. Generalized log-linear regression models were utilized to examine the association between scores on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) and sociodemographic, economic, and environmental characteristics. Regression models accounted for geographic clustering of respondents and the stratification of data collection to ensure the robustness of estimates. Results: Blacks had 6.1% (SE=0.009) lower WAB-AQ scores compared to Whites as did those who were married (β-0.030, SE=0.004) and living in the Southern US (β=-0.013, SE=0.003) even after controlling forage, environment, and aphasia type. Individuals with aphasia and living in larger families (β=0.031,SE=0.004) and those who visited their medical provider regularly (β=0.051, SE=0.002) had higher scores compared to the reference group. Income-to-poverty ratio and home ownership were significantly correlated with impairment level. The analysis indicated that having available transportation did not influence observed outcomes. Finally racial disparities did not persist at the highest income levels. Conclusion: The findings of this study suggest researcher should look beyond neurologic correlates when exploring aphasia outcomes..