Intersectional sociodemographic and neurological relationships in the naming ability of persons with post-stroke aphasia

Jacobs, Molly; Evans, Elizabeth; Ellis, Charles

doi:10.1016/j.jcomdis.2023.106352

Cited by 3 publications

(5 citation statements)

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“…Previous literature has found social support to be associated with acute aphasia impairment and life participation. We found similar findings in our prior work exploring aphasia naming ability which showed a strong association between family size and naming performance [ 27 ]. The general stroke literature has shown that families play a key role in stroke recovery [ 61 ].…”

Section: Discussionsupporting

confidence: 89%

“…This study was reviewed and approved by the institutional review board (IRB) as exempt based on the use of deidentified data and the research poses no more than minimal risk. The methodology of this project was previously reported in [ 27 ]. Data Sources : Two primary data sources were used for this study—1) AphasiaBank [ 28 ] and the 2) Medical Expenditure Panel Survey (MEPS) [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…As previously described in [ 27 ], an integrated dataset was developed using data elements common to both data sources. AphasiaBank entries were matched with up to three MEPS respondents using a propensity score algorithm [ 33 ].…”

Section: Methodsmentioning

confidence: 99%

“…Our recent work utilized a similar approach that involved merging two datasets; the Moss Aphasia Psycholinguistic Project Database (MAPPD) and the 2009–2011 Medical Expenditure Panel Survey (MEPS) to explore the influence of SDOH on naming among individuals with aphasia [ 27 ]. The study showed an association between multiple social determinants and naming performance in PWAs.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Jacobs,

Evans,

Ellis

2024

PLoS ONE

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Introduction Traditionally, the study of aphasia focused on brain trauma, clinical biomarkers, and cognitive processes, rarely considering the social determinants of health. This study evaluates the relationship between aphasia impairment and demographic, socioeconomic, and contextual determinants among people with aphasia (PWA). Methods PWA indexed within AphasiaBank—a database populated by multiple clinical aphasiology centers with standardized protocols characterizing language, neuropsychological functioning, and demographic information—were matched with respondents in the Medical Expenditure Panel Survey based on response year, age, sex, race, ethnicity, time post stroke, and mental health status. Generalized log-linear regression models with bootstrapped standard errors evaluated the association between scores on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) and demographic, economic, and contextual characteristics accounting for clustering of respondents and the stratification of data collection. Region, age, and income specific models tested the sensitivity of results. Results PWA over age 60 had 2.4% (SE = 0.020) lower WAB-R AQ scores compared with younger PWA. Compared to White PWA, Black and Hispanic PWA had 4.7% (SE = 0.03) and 0.81% (SE = 0.06) lower WAB-R AQ scores, respectively, as did those and living in the Southern US (-2.2%, SE = 0.03) even after controlling for age, family size, and aphasia type. Those living in larger families (β = 0.005, SE = 0.008), with income over $30,000 (β = 0.017, SE = 0.022), and a college degree (β = 0.030, SE = 0.035) had higher WAB-R AQ relative to their counterparts. Region-specific models showed that racial differences were only significant in the South and Midwest, while ethnic differences are only significant in the West. Sex differences only appeared in age-specific models. Racial and ethnic differences were not significant in the high-income group regression. Conclusion These findings support evidence that circumstances in which individuals live, work, and age are significantly associated with their health outcomes including aphasia impairment.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Jacobs,

Evans,

Ellis

2024

PLoS ONE

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“…Interestingly, they found the severity of aphasia played a less significant role than other social determinants. Our own recent work showed that higher income level and family size were both associated with higher confrontational naming scores among a large sample of PWA (Jacobs, Evans, & Ellis, 2023). Finally, while Connor et al (2001) found that aphasia severity was greater among PWA from lower educational backgrounds, the rate of recovery was the same regardless of socioeconomic background.…”

Section: Social Determinants Of Health and Aphasia Outcomesmentioning

confidence: 82%

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Evans,

Jacobs,

Ellis

2023

Semin Speech Lang

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Aphasia is a disorder that results from damage to portions of the brain that are responsible for language and can vary significantly by type and severity. Differences in aphasia outcomes are influenced by the social determinants of health (SDOH). The SDOH are structural, environmental, and personal determinants that influence health outcomes. Intersectionality, or how one's social and political identities interact to influence individual life outcomes and/or advantage in our society, provides a way to examine the varying levels of the SDOH. However, intersectionality is complex, difficult to measure, and has not yet been explored in post-stroke aphasia outcomes. This article reviews the relationship of race and aphasia outcomes and the SDOH and aphasia outcomes. Additionally, we provide a novel current approach to examine the SDOH and aphasia outcomes. Lastly, we discuss the need for evaluation of intersectionality in aphasia and aim to provide a leveled social–ecological framework to examine aphasia-related outcomes. With notable individual differences among aphasia outcomes, we present a framework to support optimizing research and clinical aphasia care in speech-language pathology.

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Social Networks and Communication Impairment: Racial Differences Among Stroke Survivors

Jones,

Jacobs,

Ellis

2024

Perspect ASHA SIGs

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Purpose: Recent evidence highlights the importance of social networks—the composition of social relationships—and their characteristics in stroke recovery. This study explores the relationship between social networks and poststroke communication outcomes. Method: A cohort of 30 non-Hispanic Black ( n = 12) and non-Hispanic White ( n = 18) adult stroke survivors completed the Stroke Impact Scale (SIS) Communication subtest and the Stroke Social Network Scale (SSNS). The SSNS captures elements of social networks including satisfaction and contact with friends, relatives, children, and groups. The relationship between the SIS Communication subtest scores and SSNS scores was explored using ordinal Bayesian regression estimation models adjusting for sex, age, time postonset, marital status, and stroke type. Results: Average SIS Communication scores differed ( t = 2.07, p = .335) between White ( M = 81.75, SD = 22.90) and Black ( M = 95.71, SD = 4.95) participants, but SSNS Comprehensive scores were similar between the two groups ( t = −0.89, p = 1.00). SSNS children subtest scores were higher among the Black than the White ( t = −1.73, p = .0473) participants. Similarly, satisfaction subtest scores were comparatively higher among Black than White participants ( t = 1.85, p = .451). SSNS Satisfaction, Friends, and Groups subtest scores were positively associated with SIS Communication, indicating strong associations with lower impairment. SSNS Children subtest scores were negatively related to SIS, indicating higher impairment. Although most subtest associations were similar for both groups, the associations with SSNS Children and Friends subtests differed between racial groups. Conclusions: Levels of communication impairment were correlated with child, friendship, and group attachments among participants. However, strong social ties to children and friends had different associations among racial groups.

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Intersectional sociodemographic and neurological relationships in the naming ability of persons with post-stroke aphasia

Cited by 3 publications

References 59 publications

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Social Networks and Communication Impairment: Racial Differences Among Stroke Survivors

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