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New factors that affect quality of life in patients with aphasia - 25/01/20

Doi : 10.1016/j.rehab.2019.06.015 
Bénédicte Bullier a, Hélène Cassoudesalle a, b, Marie Villain c, d, Mélanie Cogné a, e, Clémence Mollo a, Isabelle De Gabory f, Patrick Dehail a, b, Pierre-Alain Joseph a, b, Igor Sibon f, g, Bertrand Glize a, b,
a HACS team - Handicap Activité Cognition Santé, Bordeaux Population Health U1219 Inserm, University of Bordeaux, 33000 Bordeaux, France 
b Department of physical medicine and rehabilitation, CHU de Bordeaux, 33000 Bordeaux, France 
c Hôpital Pitié-Salpétrière, AP–HP, 75013 Paris, France 
d École pratique des hautes études, 75000 Paris, France 
e Department of physical medicine and rehabilitation, CHU de Rennes, 35000 Rennes, France 
f Stroke Unit, Clinical Neurosciences department, CHU de Bordeaux, 33076 Bordeaux, France 
g INCIA, CNRS UMR5287, University of Bordeaux, 33400 Talence, France 

Corresponding author at: Service MPR, place Amélie Raba Léon, 33076 Bordeaux, France.Service MPRplace Amélie Raba LéonBordeaux33076France

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Highlights

Aphasia severity, mood disorders and functional limitations are associated with poor quality of life (QoL) in individuals with post-stroke aphasia.
Fatigue is identified for the first time in this specific population and may play an important part in poor QoL.
These factors should be specifically considered in the management of post-stroke aphasia and treated if possible.

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Aphasia severity is known to affect quality of life (QoL) in stroke patients, as is mood disorders, functional limitations, limitations on activities of daily life, economic status and level of education. However, communication limitation or fatigue has not been explored in this specific population.

Objective

We aimed to investigate whether these factors were associated with QoL in patients with aphasia after stroke.

Methods

Patients with aphasia were included from April 2014 to November 2017 after a first stroke and were followed for 2 years post-stroke. QoL was assessed at follow-up by the French Sickness Impact Profile 65 (SIP-65). We explored predictors such as mood disorders, communication impairment, fatigue, limitations on activities of daily life, and aphasia severity in addition to socio-demographic factors.

Results

We included 32 individuals (22 men; mean age 60.7 [SD 16.6] years) with aphasia after a first stroke. Poor QoL as assessed by the SIP-65 was significantly associated (Pearson correlations) with increased severity of aphasia initially (P=0.008) and at follow-up (P=0.01); increased communication activity limitations at follow-up (P<0.001); increased limitations on activities of daily life at baseline (P=0.008) and follow-up (P<0.001); increased fatigue at follow-up (P=0.001); and increased depression symptoms at follow-up (P=0.001). On multivariable analysis, QoL was associated with communication activity limitations, limitations on activities of daily life, fatigue and depression, explaining more than 75% of the variance (linear regression R2=0.756, P<0.001). The relative importance in predicting the variance was 32% for limitations on activities of daily life, 21% fatigue, 23% depression and 24% communication activity limitations.

Conclusion

Aphasia severity, mood disorders and functional limitations may have a negative effect on QoL in patients with aphasia. Also, for the first time, we show that fatigue has an important impact on QoL in this population. Specific management of this symptom might be beneficial and should be explored in future studies.

El texto completo de este artículo está disponible en PDF.

Keywords : Aphasia, Quality of life, Stroke, Fatigue


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