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The Impact of Aphasia on ADL and Social Activities After Stroke: The Copenhagen Stroke Study

We conducted this study to determine whether the presence of aphasia at the time of acute admission impedes functional improvement of stroke patients and if chronic aphasia aggravates the detrimental effects of stroke on daily life functioning. Six hun dred fifty consecutive stroke patients were examined at the time of admission to hos pital, at discharge after completed acute care and rehabilitation, and six months post- stroke followup. We used the aphasia subscale of the Scandinavian Neurologic Stroke Scale, the Barthel Index (BI), and the Frenchay Activity Index (FAI). Multiple lin ear and logistic regression analyses showed that initial aphasia had a small and clini cally irrelevant influence on functional improvement and it had no influence on dis charge to independent living when controlled for initial functional status, stroke severity, comorbidity, prior stroke, age, sex, and marital status. Similar analyses showed that chronic aphasia per se had no independent influence on either the BI score or the FAI six months post-stroke. Although aphasia is a significant handicap after stroke, it does not seem to affect functional independence after stroke, nor to be of impor tance for ADL and social functions as measured by BI and FAI in a more chronic stage following stroke.