Dysphagia, dysarthria and aphasia following a first acute ischaemic stroke: incidence and associated factors

Abstract

Background and purpose Dysphagia, dysarthria and aphasia are common symptoms following acute stroke; however, limited data are available from recent prospective clinical trials. The aim of this study was to determine the incidence and associated factors of dysphagia, dysarthria and aphasia following a first acute ischaemic stroke in patients admitted to a comprehensive stroke center. Methods All first ischaemic stroke patients admitted to the Stroke Unit of Ghent University Hospital within 48 h after symptom onset were enrolled in this prospective study between March 2018 and October 2019. Dysphagia and communication screenings were performed within 3 days after admission. When dysphagia, dysarthria and/or aphasia were assumed, standardized assessments were performed. Incidence rates were calculated as point estimates (%) with 95% confidence intervals (CI). Associated factors were calculated via multivariate binary logistic regression analyses. Results Dysphagia, dysarthria and aphasia were present in 23% (95% CI, 17–31), 44% (95% CI, 37–52) and 23% (95% CI, 17–30), respectively of 151 first ischaemic stroke patients [67 female, mean age 67 (SD 14) years]. Separate multivariate binary logistic regression analyses showed that dysphagia, dysarthria and aphasia were significantly associated with age‐adjusted stroke severity at baseline [odds ratio (OR), 1.16; 95% CI, 1.09–1.23; OR, 1.13; 95% CI, 1.07–1.20 and OR, 1.11; 95% CI, 1.05–1.17 respectively]. Corrected for stroke severity, the risk for aphasia increased by 4% per year of age (OR, 1.04; 95% CI, 1.00–1.07). Adjusted for age and stroke severity, aphasia was significantly associated with large artery atherosclerosis as stroke etiology (OR, 3.91; 95% CI, 1.18–12.98). Conclusions This trial showed a high incidence of dysphagia, dysarthria and aphasia following acute ischaemic stroke. Stroke severity was an associated factor for all three symptoms.

The feasibility, usability and acceptability of a tablet-based aphasia therapy in the acute phase following stroke

“…Aphasia is a common symptom following stroke, present in 20-40 % of people in the acute phase (De Cock et al, 2020;Engelter et al, 2006;Flowers et al, 2016). Considerable spontaneous recovery is initiated in the first few months, due to neuronal plasticity and reorganization processes (Demeurisse et al, 1980;Sarno & Levita, 1971).…”

Dysarthria following acute ischemic stroke: Prospective evaluation of characteristics, type and severity

“…), it is difficult to compare our findings concerning the incidence and presentation of post‐stroke dysarthria with previous research (De Cock et al . 2020). However, there does not appear to have been a change in observed speech characteristics and severity of impairment compared with Urban et al .…”

“…Data collection was performed as part of an overarching study evaluating the incidence of dysphagia, dysarthria and aphasia following a first ischemic stroke (De Cock et al . 2020). Inclusion criteria for this study were (1) diagnosis of a first‐ever ischemic stroke; (2) minimum age of 18 years; (3) Dutch speaking; and (4) admitted within 48 h after the onset of acute stroke symptoms to the Stroke Unit of the Ghent University Hospital.…”

“…More detailed information on data collection and study protocol is described by De Cock et al . (2020).…”

Implementation of online psychosocial interventions for people with neurological conditions and their caregivers: A systematic review protocol

“…People with neurological conditions commonly present with cognitive, behavioural and psychological symptoms 2 – 5 and communication impairments 6 , 7 that can have enduring psychosocial impacts. For directly affected individuals, these include difficulties with mental health, 8 – 10 employment 11 , 12 and social participation and relationships.…”