title: Determinants of Living Well With Aphasia in the First Year Poststroke: A Prospective Cohort Study.
abstract: OBJECTIVE
  To determine factors that contribute to living well with aphasia in the first 12 months poststroke.
  
  
  METHODS
  Prospective longitudinal cohort study.
  
  
  METHODS
  Hospitalized care, ambulatory care, and general community.
  
  
  METHODS
  A referred sample of people (N=58) with a first incidence of aphasia after stroke was assessed at 3, 6, 9, and 12 months postonset. Participants were recruited through speech-language pathologists in 2 capital cities in Australia. Presence of aphasia was determined through the Western Aphasia Battery-Revised by an experienced speech-language pathologist.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The main outcomes were the 5 domains of the Assessment for Living with Aphasia at 3, 6, 9, and 12 months poststroke. The independent variables included demographics, physical functioning, social network, mood, aphasia severity, and a self-rating of successfully living with aphasia at the same time points. Mixed effects modeling was used to determine which factors contributed to the trajectory of each of the 5 domains of participation, impairment, environment, personal factors, and life with aphasia.
  
  
  RESULTS
  Higher household income, larger social network size, being a woman, and having milder aphasia were positively associated with the participation domain. Graduate or postgraduate educational levels, low mood, and poor physical functioning were negatively associated with the participation domain. Factors positively associated with other domains included higher income, self-ratings of successfully living with aphasia, and aphasia severity. Low mood was consistently negatively associated with all of the domains.
  
  
  CONCLUSIONS
  Psychosocial determinants were the most significant predictors of living well with aphasia in the first 12 months postonset. Aphasia rehabilitation needs to attend more to these factors to optimize outcomes.
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia. Electronic address: l.worrall@uq.edu.au.
authors.forename: Linda E
authors.initials: LE
authors.lastname: Worrall
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Kyla
authors.initials: K
authors.lastname: Hudson
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Asaduzzaman
authors.initials: A
authors.lastname: Khan
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Brooke
authors.initials: B
authors.lastname: Ryan
authors.affiliation: Health and Human Sciences, Southeastern Louisiana University, Hammond, LA.
authors.forename: Nina
authors.initials: N
authors.lastname: Simmons-Mackie
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology* / Q000523:psychology / Q000534:rehabilitation*; D001315:Australia; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D012959:Socioeconomic Factors; D013066:Speech-Language Pathology / Q000379:methods*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation / Q000379:methods*
keywords: Aphasia; International Classification of Functioning, Disability and Health; Language disorders; Patient outcome assessment; Quality of life; Rehabilitation; Social determinants of health; Speech-language pathology; Stroke