“Struggling to stay connected”: comparing the social relationships of healthy older people and people with stroke and aphasia

ABSTRACT

Background: Having a stroke and aphasia can profoundly affect a person’s social relationships. Further, poor social support is associated with adverse post-stroke outcomes such as psychological distress, worse quality of life, and worse recovery. To date, no study has used complex measures of social network and perceived social support to compare stroke survivors with aphasia, without aphasia, and the general older population. A better understanding of which aspects of social support are most affected by stroke and aphasia may inform stroke services.

Aims: To compare the social networks and perceived functional social support of people following a stroke, with and without aphasia, and healthy older adults.

Methods & Procedures: Cross-sectional interview-based study. People with a first stroke were recruited from two acute stroke units and interviewed 6 months post onset. We recruited 60 stroke participants without aphasia, average age 69.8 (SD = 14.3), and 11 stroke participants with aphasia, average age 66.5 (SD = 13.7). One hundred and six healthy older adults were recruited via the community, average age 62.8 (SD = 9.5). All participants completed the Medical Outcomes Study Social Support Survey (SSS) and the Stroke Social Network Scale (SSNS). One-way independent groups ANOVAs were used to compare stroke participants with aphasia, stroke participants without aphasia, and healthy older adults.

Outcomes & Results: After adjusting for multiple comparisons (p < .004), there was a significant difference on overall social network between the three groups (p < .001), with those with aphasia scoring significantly lower than healthy older adults (p < .001). The difference between healthy older adults and people with aphasia on the friends domain of the social network scale was also significant (p = .002). There was no significant difference between the three groups on overall perceived functional social support.

Conclusions: People with aphasia have less diverse social networks than healthy older adults, with friendships particularly affected. Stroke services should monitor for social isolation, and consider ways to support people following a stroke in maintaining or establishing diverse social networks.

KEYWORDS:

• Social support
• social network
• stroke
• aphasia

Acknowledgements

The authors would like to thank all the participants as well as the stroke teams of St Mary’s Hospital and the Royal Free Hospital in London. We would also like to thank Charlotte Bower, Shima Yazdi, Lorraine Omeku, Suneet Cheema, Natalie Lower, Samantha Baddick, and Dorothy Young who all contributed to the data collection for this project.

Disclosure statement

No potential conflict of interest was reported by the authors.