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

Area of Science:

• Neurology
• Public Health
• Speech-Language Pathology

Background:

• Social determinants of health (SDOHs) significantly influence health trajectories.
• Post-stroke aphasia is a common and persistent communication impairment.
• Understanding the interplay between SDOHs and aphasia is crucial for equitable care.

Purpose of the Study:

• To conduct a scoping review on five individual social determinants of health (SDOHs): gender, education, ethnicity, socioeconomic status, and social support.
• To examine the relationship between these SDOHs and post-stroke aphasia outcomes, including recovery and intervention response.

Main Methods:

• A comprehensive literature search was performed across five databases (2020, updated 2022).
• Twenty-five studies involving 3363 participants met the inclusion criteria.
• Data on SDOHs and aphasia outcomes were extracted and descriptively analyzed.

Main Results:

• Twenty studies reported on SDOHs and aphasia recovery; five on SDOHs and intervention response.
• Most research focused on language outcomes (14 studies), with less on activity, participation, and quality of life (6 studies).
• No evidence linked gender or education to early language outcomes; SDOHs may influence outcomes at or beyond 12 months post-stroke.

Conclusions:

• Research on SDOHs and aphasia outcomes is nascent.
• SDOHs are modifiable and influence health across the lifespan.
• Further investigation into the long-term impact of SDOHs on aphasia is urgently needed.