SLPOtherJournal of communication disorders2022

Aphasia severity is modulated by race and lesion size in chronic survivors: A retrospective study.

Davetrina S Gadson, Deliya B Wesley, Candace M van der Stelt and 4 others

PMID 36215784

WHAT IT FOUND

Average aphasia severity did not differ significantly between Black and White stroke survivors, but larger lesions were associated with lower language scores in Black survivors more than White survivors.

Key findings

01Average aphasia severity did not differ significantly between Black and White stroke survivors, despite a numerical difference of 6 points on the WAB Aphasia Quotient.

02Larger lesion size was associated with lower aphasia quotient scores, and lesion size interacted with race so that Black survivors with larger lesions had lower scores than White survivors.

03Black survivors had lower years of education and lower estimated zip code median income than White survivors.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study was retrospective and used a convenience sample of research volunteers, so it was not representative of all stroke survivors with aphasia. The proportion of Black survivors was lower than local stroke rates, and the authors said the results are preliminary and not definitive. The sample was small. Over 500 participants would be needed to detect the aphasia severity difference with 80% power, and over 1300 would be needed to detect the lesion size difference. Income was estimated from zip code and was not confirmed by participants. The WAB-R has limited normative data for Black Americans, so assessment bias is possible. The null finding for white matter disease was not conclusive.

Declared interests

The supplied article text does not include a conflicts or funding declaration. The publication types indicate NIH and non-U.S. government research support.

The easy way to misread this

Do not conclude that race alone causes worse aphasia. The average aphasia severity difference was not significant. The significant finding was an interaction with lesion size, and this retrospective study cannot show cause.

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