title: Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis.
abstract: OBJECTIVE
  In a geographically defined population, we assessed incidence and determinants of aphasia attributable to first-ever ischemic stroke (FEIS).
  
  
  METHODS
  A 1-year prospective, population-based study among the permanent residents of the canton Basle City, Switzerland, was performed using multiple overlapping sources of information.
  
  
  RESULTS
  Among 188,015 inhabitants, 269 patients had FEIS, of whom 80 (30%; 95% CI, 24 to 36) had aphasia. The overall incidence rate of aphasia attributable to FEIS amounted to 43 per 100,000 inhabitants (95% CI, 33 to 52). Aphasic stroke patients were older than nonaphasic patients. The risk of aphasia attributable to FEIS increased by 4% (95% CI, 1% to 7%), and after controlling for atrial fibrillation, by 3% (95% CI, 1% to 7%) with each year of patients' age. Gender had no effect on incidence, severity, or fluency of aphasia. Cardioembolism was more frequent in aphasic stroke patients than in nonaphasic ones (odds ratio [OR], 1.85; 95% CI, 1.07 to 3.20). Aphasic patients sought medical help earlier than nonaphasic stroke patients. Still, after controlling for stroke onset-assessment interval, aphasic stroke patients were more likely to receive thrombolysis than nonaphasics (OR, 3.5; 95% CI, 1.12 to 10.96).
  
  
  CONCLUSIONS
  Annually, 43 of 100,000 inhabitants had aphasia resulting from first ischemic stroke. Advancing age and cardioembolism were associated with an increased risk for aphasia. Severity and fluency of aphasia were not affected by demographic variables.
authors.affiliation: Stroke Unit, University Hospital Basle, Switzerland. sengelter@uhbs.ch
authors.forename: Stefan T
authors.initials: ST
authors.lastname: Engelter
authors.forename: Michal
authors.initials: M
authors.lastname: Gostynski
authors.forename: Susanna
authors.initials: S
authors.lastname: Papa
authors.forename: Maya
authors.initials: M
authors.lastname: Frei
authors.forename: Claudia
authors.initials: C
authors.lastname: Born
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
authors.forename: Felix
authors.initials: F
authors.lastname: Gutzwiller
authors.forename: Phillipe A
authors.initials: PA
authors.lastname: Lyrer
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001037:Aphasia / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D003331:Coronary Vessels; D004617:Embolism / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D020521:Stroke / Q000150:complications* / Q000188:drug therapy*; D015912:Thrombolytic Therapy