Aphasia after stroke: natural history and associated deficits.

TLDR

In a Health District of 250,000 people, about 60 patients each year are referred for speech therapy after an acute stroke. Data from a community survey of 215,000 people over 28 months were analysed for 976 acute stroke patients to chart the natural history of speech disturbance. Among 545 patients assessed within 7 days, 24% were aphasic, falling to 20% at 3 weeks and 12% at 6 months, with 40% of early aphasic cases persisting at 6 months; early and late aphasia scores were highly correlated and aphasia was associated with greater disability and poorer social recovery but did not increase caregiver stress.

Abstract

Data relating to 976 patients registered as suffering an acute stroke has been analysed to determine the natural history of speech disturbance: these patients came from a community survey of 215,000 people over a 28 month period. Of the 545 patients assessed within 7 days of stroke, 24% were aphasic and 28% unassessable. At 3 weeks, when over 90% of survivors were tested, 20% of those tested had aphasia. At 6 months only 12% of survivors had significant aphasia, but 44% of patients and 57% of carers thought speech was abnormal. Of those aphasic within 7 days, 40% remained so at 6 months; 60% of those aphasic at 3 weeks remained so. There was a high correlation between early and late aphasia scores. Aphasia was associated with more severe disability (degree of limb weakness, loss of function, loss of IQ), and with a less good recovery of social activities, but did not cause any measurable increase in stress upon carers. In a Health District of 250,000 people, about 60 patients each year may be referred for speech therapy after an acute stroke.