Communication skills fifteen years after vascular aphasia

Abstract

Aphasia is a common deficiency that profoundly impairs daily communication. The aim of this study was to describe the severity of aphasia and participation restrictions in daily life communication activities in daily life 10 years or more after a stroke. We included patients with aphasia following a stroke before January 2004 from the Archives of Physical Medicine and Rehabilitation department of Pitié-Salpêtrière hospital and from patient associations. Initial clinical and demographic data were collected retrospectively. The severity of aphasia was assessed by the Aphasia Severity Rating Scale (ASRS) and communication skills in daily life by a French communication scale (Échelle de Communication Verbale de Bordeaux). 20 patients have been included, mean age 44 years; acute phase aphasia was always severe. Assessment was conducted 10 to 25 years after the onset (mean 16.8 years), 55% of patients had mild aphasia (ASRS 4–5), 25% moderate aphasia (ASRS 3) and 20% severe aphasia (ASRS 1–2). The most impaired communication skills were reading and writing administrative documents, having a conversation on a complicated subject and conversing with a stranger. Long-term assessment of communication skills shows that 45% of aphasic patients keep significant language impairments. Communication ability, concurring the severity of aphasia, is disturbed at various levels. Personal life seems preserved but vocational integration remains rare.