Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Do Social Determinants of Health Influence Post-Stroke Aphasia Outcomes? A Scoping Review (#12)

Robyn O'Halloran 1 , Joanne Renton 2 , Sam Harvey 1 2 3 , Marie-Pier McSween 2 3 , Sarah J Wallace 2 3
  1. NHMRC CRE in Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Victoria, Australia
  2. Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia
  3. Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Brisbane, Queensland, Australia

Background: Factors known to influence language outcomes post-stroke include lesion factors, age, severity, cognition, and overall health. These factors account for 51% of the variance in language outcomes. Little is known about what else contributes to language outcomes and what might predict other post-stroke aphasia outcomes such as participation and quality of life. Social Determinants of Health (SDoHs) are the conditions in which people are born, grow, work, and live. Recent research indicates that SDoHs influence incidence of stroke and may influence post-stroke rehabilitation outcomes. The role of SDoHs on post-stroke aphasia outcomes is unknown.

Aims: To examine the literature on five individual SDoHs (gender, education, ethnicity, socioeconomic status, and social support) on post-stroke aphasia outcomes (language, participation, environmental factors, personal factors, and quality of life).

Methods: A scoping review was conducted according to PRISMA-Scoping Review guidelines. Terms were searched across five databases: PubMed, Scopus, PsychINFO, CINAHL and Embase in August 2020 and again in February 2022. Studies were included if they were published in French or English, included adults with post-stroke aphasia, and examined the relationship between any individual SDoH and any aphasia outcome.

Results: Twenty-five studies were identified that explored relationships between SDoHs and aphasia recovery (n=20) and SDoHs and aphasia treatment outcomes (n=5). Most research investigated the relationship between gender and education and language recovery. Very little research was identified on SDoHs and other aphasia outcomes. Statistically significant relationships between SDoHs and recovery or outcomes were only identified at or beyond 12 months post-stroke.

Conclusion: Research is needed on SDoHs and aphasia recovery and outcomes, particularly at and beyond 12 months post-stroke. Understanding the role of SDoHs on aphasia recovery and outcomes will be important to ensure optimal care for all stroke survivors with aphasia long term.