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19-12-2011 | Speech-language pathology | Article

Depression and communication disability affects QoL in aphasic patients


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MedWire News: Distress, depression, the extent of aphasic impairment, and communication disability are significant predictors of quality of life (QoL) in individuals with aphasia following a stroke, research shows.

In addition, other medical conditions, physical activity levels, and the extent of social support, also impact health-related quality-of-life (HRQoL), report Katerina Hillari (City University London, UK) and colleagues.

There is a need for further research, state the researchers, "first to explore these factors in detail and determine the main predictors of HRQL, and second to identify what interventions can best address these."

Approximately one-third of stroke survivors have aphasia at stroke onset, and as many as 15% remain aphasic in the long term.

Evidence suggests that aphasia, a disorder affecting use and understanding of language, "has a profound effect on people's lives," say the researchers.

In the Archives of Physical and Medical Rehabilitation, Hillari and colleagues performed a meta-analysis to determine factors associated with poor HRQoL in patients with post-stroke aphasia.

Fourteen studies were reviewed and multiple factors were identified as having an impact on HRQoL.

In the qualitative studies, which included 98 people with aphasia, activity level, verbal communication, body functioning, mobility, positive personal outlook, independence, and general health all influenced HRQoL.

In the quantitative studies, which included 742 people with post-stroke aphasia, aphasia severity/language impairment, communication disability, and distress/depression, were consistently associated with HRQoL.

The elderly and women tended to be more severely affected in terms of quality-of-life measures, and diminished physical activity and a reduced social network also negatively affected HRQoL.

Depression appears to be more of a problem for people with aphasia, "where the frequency of depression is higher than for other stroke survivors," according to the researchers.

Also, depression following a stroke has been linked with poor recovery, poor functional outcomes, poor social outcomes, increased healthcare use, and mortality, they add.

The group noted that a number of studies on HRQoL after stroke could not be included because of limited reporting on subjects with aphasia.

Future studies are needed, particularly longitudinal studies, to determine how these factors influencing HRQOL affect long-term clinical outcomes.

Interventions that aim to improve HRQOL for people with aphasia by targeting these factors, including depression, communication disability, and engagement in activities, among others, also need to be tested, conclude Hillari and colleagues.

By MedWire Reporters

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