Racial disparities in post-stroke aphasia: A need to look beyond the base analysis

Racial disparities have been reported in post-stroke conditions such as aphasia, yet findings have been inconsistent. Prior studies have generally included small numbers of people of color for comparisons of outcome. Consequently, it is unclear if the racial disparities that are consistently observed in stroke, the primary cause of aphasia, parallel disparities in aphasia outcomes.

In this study we examined aphasia outcomes among Black and White persons with aphasia (PWA) based on data from the Moss Aphasia Psycholinguistics Project Database (MAPPD).

In initial comparisons of the measures of aphasia impairment (Western Aphasia Battery-Revised Aphasia Quotient; WAB-R AQ), White PWA exhibited greater impairment than Black PWA. However, after adjusting for aphasia type, age, sex, estimates Blacks exhibited lower average WAB AQs.

This study illustrates how more sophisticated statistical methods should be used to examine racial differences in aphasia and other communication outcomes particularly given differences commonly observed sociodemographic characteristics that are present in the primary cause of the disorders. Without careful analysis of data and consideration of its implications, researchers and clinicians will continue to ignore key differences in clinical populations that influence aphasia outcomes. More importantly, in order to grow knowledge in the field and a continue to improve clinical outcomes, the field must fully exploit tools of empirical analysis and focus their research on discovering, adapting and improving the lives of all individuals with aphasia.