Ann Rehabil Med.  2020 Jun;44(3):171-180. 10.5535/arm.19096.

Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic

• Seo KC
• Ko JY
• Kim TU
• Lee SJ
• Hyun JK
• Kim SY

• KMID: 2504437
• DOI: http://doi.org/10.5535/arm.19096

Abstract

Objective
To investigate the comprehensive outcomes in aphasic patients, including their cognitive and functional status after ischemic or hemorrhagic stroke. It also aimed to clarify whether aphasia is a prognostic factor for cognitive and functional improvements in stroke patients.
Methods
Sixty-seven ischemic or hemorrhagic stroke patients in the subacute stage who had been diagnosed with aphasia using the Korean version of Frenchay Aphasia Screening Test (K-FAST) were included in the study. Forty-six stroke patients without aphasia were used as controls. All patients were examined with the Korean version of the Western Aphasia Battery (K-WAB). Cognitive and functional assessments of the patients including the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of Modified Barthel Index (K-MBI) were performed during admission and 4 weeks after the initial assessments.
Results
The initial and follow-up total K-MMSE and K-MBI scores were significantly lower in aphasic patients than in non-aphasic controls. The K-WAB scores highly correlated with the total K-MMSE scores at the follow-up stage in all aphasic stroke patients. The K-WAB scores moderately correlated with the follow-up scores of the K-MBI in ischemic stroke patients but not in hemorrhagic stroke patients.
Conclusion
Aphasia influences the cognitive and functional status of stroke patients and has a greater impact on cognitive improvement. Aphasia severity can be one of the prognostic factors for cognitive status in aphasic patients with stroke.

Keyword

Aphasia; Stroke; Prognosis; Cognitive dysfunction

Figure

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  Fig. 1. Regression analysis of (A, C, E) K-MMSE and (B, D, F) K-MBI total scores in all stroke patients with aphasia (A, B), ischemic stroke patients with aphasia (C, D), and hemorrhagic stroke patients with aphasia (E, F) at follow-up according to K-WAB Aphasia Quotient (AQ) at admission. The solid lines indicate regression lines. K-MMSE, Korean version of Mini-Mental State Examination; K-MBI, Korean version of Modified Barthel Index; K-WAB, Korean version of Western Aphasia Battery.

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  Fig. 2. Regression analysis of (A) K-MMSE, and (B) K-MBI gain scores during follow-up period according to K-WAB Aphasia Quotient (AQ) at admission. The solid lines indicate regression lines. K-MMSE, Korean version of Mini-Mental State Examination; K-MBI, Korean version of Modified Barthel Index; K-WAB, Korean version of Western Aphasia Battery.

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