Browsing by Author "Bruce, Rachel"
Now showing 1 - 1 of 1
Results Per Page
Sort Options
Publication The impact of pre-stroke formal education on language testperformance in aphasic and non-aphasic stroke survivors(2024) Roberts, Sophie M.; Bruce, Rachel; Hope, Thomas M.H.; Geva, Sharon; Anderson, Storm; Woodgate, Hayley; Ledingham, Kate; Gajardo-Vidal, Andrea; Lorca-Puls, Diego L.; Crinione, Jennifer T.; Leff, Alexander P.; Green, David W.; Price, Cathy J.Background: A greater amount of education is known to positivelyimpact language skills in neurotypical populations, but its influenceon language outcomes and recovery after stroke remains unclear.Aims: This study of 749 stroke survivors, with and without aphasia,investigated (A) which aphasia assessment tasks benefitted mostfrom more pre-stroke education; and whether the effect of educa-tion (B) differs for aphasic and non-aphasic participants or otherstroke and non-stroke-related variables, and/or (C) facilitates recov-ery from post-stroke aphasia.Methods: Participants ranged from one month to 42 years post-stroke. They were assessed using (i) the Comprehensive AphasiaTest (CAT), and (ii) self-report questionnaires that measured speechproduction, comprehension, reading, and writing at one week andone year post-stroke. Multiple regression analyses investigated theeffect of education amount, and its interaction with other variables,on language outcomes and recovery. Bayesian statistics assessedthe strength of the evidence for any observed effects. Many vari-ables including lesion size, age at stroke, and initial severity werecontrolled for.Results: (A) More years of formal education were associated withbetter overall language skills, with significant, albeit small effectsfound for semantic and letter fluency (β = 0.123 and 0.166) andspoken picture description, specifically, the number of words pro-duced (β = 0.085) and grammatical well-formedness (β = 0.087). (B)The benefit of more pre-stroke education was mostly additive withthe effects of other variables including initial aphasia severity andleft hemisphere lesion size, but was reduced in older participants who had large lesions with severe initial symptoms. Finally, (C) nosignificant effect of education on language recovery was observed.Conclusion: More pre-stroke formal education is associated withhigher post-stroke language scores on a wide range of tasks forboth aphasic and non-aphasic participants, but, in participants withlarge lesions that cause severe aphasia, this advantage diminisheswith age. These results suggest a generic benefit of education onlanguage test performance rather than a specific role of pre-strokeeducation in aiding language outcomes and recovery. An indivi-dual’s educational background should therefore be consideredwhen interpreting assessment scores.