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Reviews

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

ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon & ORCID Icon
Pages 1274-1287 | Received 17 Aug 2022, Accepted 16 Mar 2023, Published online: 03 Apr 2023
 

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 REHABILITATION

  • Research 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.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Sarah J. Wallace is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (1175821).