A Comparative Study of Quality of Life Based on the Severity of Stroke-Induced Aphasia in Home-Dwelling Elderly: Quality of Life of Elderly Individuals Across Different Severity Levels of Aphasia

Objectives: Natural aging is accompanied by declines in physical, sensory, psychomotor, and cognitive areas.When these natural reductions occur alongside a chronic illness such as aphasia resulting from a stroke, they can significantly impact an individual's quality of life.This study aimed to examine and compare the quality of life of Iranian elderly individuals with stroke across different severities of aphasia. Materials and Methods:This cross-sectional study was conducted in the years 2022-2023 involving 56 Persian-speaking individuals aged 60 and older diagnosed with aphasia, classified into three severity levels: mild (21 participants), moderate (14 participants), and severe (21 participants) using the Clinical Screening Version of Persian Diagnostic Aphasia Battery (P-DAB-1).Participants were predominantly selected from Tehran, with a small number from Shiraz, Kerman, and Amol using non-probability sampling.Subsequently, the Stroke and Aphasia Quality of Life scale (SAQOL-39) was completed by the people with aphasia.To analyze the data, descriptive statistical tests such as mean and standard deviation were utilized to summarize and describe the main characteristics of the data.The Shapiro-Wilk test was employed to assess data normality.One-way ANOVA was used to examine differences between groups, and Tukey's posthoc test was applied to identify differing groups.To examine the impact of age groups and stroke onset time on the quality of life of patients, analysis of covariance (ANCOVA) was used.The age groups and time since stroke were considered as independent variables, while the quality of life score was treated as the dependent variable.Furthermore, Pearson correlation coefficient was used to investigate the relationships between variables.Data analysis was performed using SPSS version 26, with a significance level of 0.05 for all tests and 0.001 for the correlation coefficient.Results: A total of 30 men and 26 women participated in the study, with a mean age of 68.61 years (age range: 60-90 years) and a mean stroke duration of 18.30 months (range: 1-120 months).Significant differences were observed between severe and mild aphasia in the overall quality of life score and the communication subscale of the SAQOL-39, as well as between moderate and severe aphasia in the physical subscale (p<0.05).However, no significant differences were noted in the psychosocial and energy subscales (p>0.05).Age (p = 0.466) and stroke onset time (p = 0.209) did not have a significant impact on quality of life.A strong positive correlation existed between the communication dimension and the severity of aphasia (p<0.001,r=0.51), and moderate correlations were found regarding the total tool score (p<0.001,r=0.37), as well as for psychosocial (p<0.001,r=0.36), physical, and energy subscales (p<0.001,r=0.23). Conclusions:As the severity of aphasia increases, the quality of life scores of elderly individuals with stroke decline.These findings highlight the significance of considering disease severity in assessing the quality of life of older adults and can guide therapeutic and supportive interventions.