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Cited by 25Neurobiology of Language and BilingualismStroke Rehabilitation and RecoveryDysphagia Assessment and Management

Do social determinants influence post-stroke aphasia outcomes? A scoping review

Open access
O'Halloran, Robyn, Renton, Joanne, Harvey, Sam, McSween, Marie-Pier, Wallace, Sarah J.·2024·Disability and Rehabilitation
DOI 10.1080/09638288.2023.2193760
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Abstract

Purpose To conduct a scoping review on five individual social determinants of health (SDOHs): gender, education, ethnicity, socioeconomic status, and social support, in relation to post-stroke aphasia outcomes.Materials and methods A comprehensive search across five databases was conducted in 2020 and updated in 2022. Twenty-five studies (3363 participants) met the inclusion criteria. Data on SDOHs and aphasia outcomes were extracted and analysed descriptively.Results Twenty studies provide information on SDOH and aphasia recovery outcomes. Five studies provide insights on SDOH and response to aphasia intervention. Research on SDOH and aphasia recovery has predominantly focussed solely on language outcomes (14 studies), with less research on the role of SDOH on activity, participation, and quality of life outcomes (6 studies). There is no evidence to support a role for gender or education on language outcomes in the first 3 months post stroke. SDOHs may influence aphasia outcomes at or beyond 12 months post onset.Conclusions Research on SDOHs and aphasia outcomes is in its infancy. Given SDOHs are modifiable and operate over a lifetime, and aphasia is a chronic condition, there is a pressing need to understand the role of SDOHs on aphasia outcomes in the long term.Implications for rehabilitationResearch on the role of Social Determinants of Health (SDoH) and aphasia outcomes is in its infancy.The role of SDoHs has been mainly investigated in relation to language outcomes.Little is known about the SDoHs on activity, participation, and quality of life outcomes.Rehabilitation professionals should consider the potential influence of individual SDoHs such as gender, education, socioeconomic status, ethnicity, and social support on a person's access to aphasia services and aphasia outcomes long term.

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  • Education influences inter-individual variability in treated language improvement in post-stroke aphasia.

    “It is well established that inter-individual variability in TLI in post-stroke aphasia is influenced by an array of factors, including, but not limited to, age12–15, education16–19, aphasia severity11,14,15,20,21, baseline cognitive abilities13,22,23, and, specific to bPWA, bilingual language experience and language of treatment (e.g., whether therapy is delivered in L1 or L2)24,25.”

    From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [19]

    The Education section reports associations between education and some measures of language recovery after stroke. But it distinguishes recovery from response to treatment and says there is insufficient research to conclude that education affects treatment response. It therefore does not support the claim that education is an established influence on treated language improvement. (LLM, conf=0.88)

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  • A recent systematic review of social determinants of health found that while there is no evidence to support a role for education in language outcomes before 12 months post-stroke, the limited research available with PWA at or beyond 12 months indicates education may play a role in language outcomes over time.

    “Indeed, a recent systematic review of social determinants of health found that while there is no evidence to support a role for education in language outcomes before 12 months post-stroke, the limited research available with PWA at or beyond 12 months indicates education may play a role in language outcomes over time19.”

    From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [19]

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Research works printed but not linked: 1

  1. Lee S, Na Y, Tae W-S, et al. Clinical and neuroimaging factors associated with aphasia severity in stroke patients: diffusion tensor imaging study. Sci Rep. 2020;10:1-12.

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Authors
O'Halloran, R., Renton, J., Harvey, S., McSween, M.-P., & Wallace, S. J.
Affiliations
  • NHMRC Centre for Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
  • The University of Queensland (AU)
  • La Trobe University (AU)
ORCID
Venue
Disability and Rehabilitation
Publisher
Informa UK Limited
Published
2023-04-03
Volume
46
Issue
7
Pages
1274-1287
ISSN
  • 0963-8288 (ISSN-L)
  • 1464-5165
DOI
10.1080/09638288.2023.2193760
OpenAlex
W4362506844
Cited by
25
References
63
Citations by year
2026: 4 · 2025: 5 · 2024: 11 · 2023: 5
FWCI
3.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Disability and Rehabilitation (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
  • La Trobe University (cc-by)
Funders
National Health and Medical Research Council (1175821)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
Keywords
social determinants of health, post-stroke aphasia, aphasia recovery, gender, ethnicity, socioeconomic status, social support, language outcomes, activities and participation, quality of life, aphasia rehabilitation
MeSH terms
Stroke Rehabilitation, Aphasia, Educational Status, Female, Humans, Male, Quality of Life, Sex Factors, Social Class, Social Support, Stroke, Social Determinants of Health

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