Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2024

Open Access 01-12-2024 | Aphasia | Research

Meta-analysis and systematic review of the relationship between sex and the risk or incidence of poststroke aphasia and its types

Authors: Ting-ting Li, Ping-ping Zhang, Ming-chen Zhang, Hui Zhang, Hong-ying Wang, Ying Yuan, Shan-lin Wu, Xiao-wen Wang, Zhong-guang Sun

Published in: BMC Geriatrics | Issue 1/2024

Login to get access

Abstract

Objective

To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice.

Data sources

Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023.

Study selection

Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex.

Data extraction

Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded.

Data synthesis

36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19–1.29, P < 0.001), with a prevalence of PSA of 31% in men and 36% in women, and an overall prevalence of 34% (P < 0.001). Analysis of the risk of the different types of aphasia in 1,048 patients with PSA showed a high risk in females for global, broca and Wenicke aphasia, and a high risk in males for anomic, conductive and transcortical aphasia, which was not statistically significant by meta-analysis. The incidence of global aphasia (males vs. females, 29% vs. 32%) and broca aphasia (17% vs 19%) were higher in females, and anomic aphasia (19% vs 14%) was higher in males, which was statistically significant (P < 0.05).

Conclusions

There are gender differences in the incidence and types of PSA. The risk of PSA in female is higher than that in male.
Appendix
Available only for authorised users
Literature
1.
Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, Fisher M, Pandian J, Lindsay P. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022;17(1):18–29.PubMedCrossRef
2.
Stipancic KL, Borders JC, Brates D, Thibeault SL. Prospective Investigation of Incidence and Co-Occurrence of Dysphagia, Dysarthria, and Aphasia Following Ischemic Stroke. Am J Speech Lang Pathol. 2019;28(1):188–94.PubMedCrossRef
3.
Wu C, Qin Y, Lin Z, Yi X, Wei X, Ruan Y, He J. Prevalence and Impact of Aphasia among Patients Admitted with Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2020;29(5):104764.PubMedCrossRef
4.
Grönberg A, Henriksson I, Stenman M, Lindgren AG. Incidence of Aphasia in Ischemic Stroke. Neuroepidemiology. 2022;56(3):174–82.PubMedCrossRef
5.
Flowers HL, Skoretz SA, Silver FL, Rochon E, Fang J, Flamand-Roze C, Martino R. Poststroke Aphasia Frequency, Recovery, and Outcomes: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2016;97(12):2188-2201.e2188.PubMedCrossRef
6.
7.
De Cock E, Batens K, Hemelsoet D, Boon P, Oostra K, De Herdt V. Dysphagia, dysarthria and aphasia following a first acute ischaemic stroke: incidence and associated factors. Eur J Neurol. 2020;27(10):2014–21.PubMedCrossRef
8.
Inatomi Y, Yonehara T, Omiya S, Hashimoto Y, Hirano T, Uchino M. Aphasia during the acute phase in ischemic stroke. Cerebrovasc Dis. 2008;25(4):316–23.PubMedCrossRef
9.
Watila MM, Balarabe SA. Factors predicting post-stroke aphasia recovery. J Neurol Sci. 2015;352(1–2):12–8.PubMed
10.
Sharma S, Briley PM, Wright HH, Perry JL, Fang X, Ellis C. Gender differences in aphasia outcomes: evidence from the AphasiaBank. Int J Lang Commun Disord. 2019;54(5):806–13.PubMedCrossRef
11.
12.
Lima RR, Rose ML, Lima HN, Cabral NL, Silveira NC, Massi GA. Prevalence of aphasia after stroke in a hospital population in southern Brazil: a retrospective cohort study. Top Stroke Rehabil. 2020;27(3):215–23.PubMedCrossRef
13.
Kadojić D, Bijelić BR, Radanović R, Porobić M, Rimac J, Dikanović M. Aphasia in patients with ischemic stroke. Acta Clin Croat. 2012;51(2):221–5.PubMed
14.
Bhatnagar SC, Jain SK, Bihari M, Bansal NK, Pauranik A, Jain DC, Bhatnagar MK, Meheshwari MC, Gupta M, Padma MV. Aphasia type and aging in Hindi-speaking stroke patients. Brain Lang. 2002;83(2):353–61.PubMedCrossRef
15.
Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CD, Giroud M, Rudd A, Ghetti A, Inzitari D. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry. Stroke. 2003;34(5):1114–9.PubMedCrossRef
16.
Godefroy O, Dubois C, Debachy B, Leclerc M, Kreisler A. Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke. 2002;33(3):702–5.PubMedCrossRef
17.
Trapl M, Eckhardt R, Bosak P, Brainin M. Early recognition of speech and speech-associated disorders after acute stroke. Wien Med Wochenschr. 2004;154(23–24):571–6.PubMedCrossRef
18.
Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis The Copenhagen aphasia study. Cerebrovasc Dis. 2004;17(1):35–43.PubMedCrossRef
19.
Engelter ST, Gostynski M, Papa S, Frei M, Born C, Ajdacic-Gross V, Gutzwiller F, Lyrer PA. Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke. 2006;37(6):1379–84.PubMedCrossRef
20.
Kyrozis A, Potagas C, Ghika A, Tsimpouris PK, Virvidaki ES, Vemmos KN. Incidence and predictors of post-stroke aphasia: the Arcadia Stroke Registry. Eur J Neurol. 2009;16(6):733–9.PubMedCrossRef
21.
Brkić E, Sinanović O, Vidović M, Smajlović D. Incidence and clinical phenomenology of aphasic disorders after stroke. Med Arh. 2009;63(4):197–9.PubMed
22.
Bersano A, Burgio F, Gattinoni M, Candelise L. Aphasia burden to hospitalised acute stroke patients: need for an early rehabilitation programme. Int J Stroke. 2009;4(6):443–7.PubMedCrossRef
23.
Naess H, Hammersvik L, Skeie GO. Aphasia among young patients with ischemic stroke on long-term follow-up. J Stroke Cerebrovasc Dis. 2009;18(4):247–50.PubMedCrossRef
24.
Tsouli S, Kyritsis AP, Tsagalis G, Virvidaki E, Vemmos KN. Significance of aphasia after first-ever acute stroke: impact on early and late outcomes. Neuroepidemiology. 2009;33(2):96–102.PubMedCrossRef
25.
Dickey L, Kagan A, Lindsay MP, Fang J, Rowland A, Black S. Incidence and profile of inpatient stroke-induced aphasia in Ontario. Canada Arch Phys Med Rehabil. 2010;91(2):196–202.PubMedCrossRef
26.
Gialanella B. Aphasia assessment and functional outcome prediction in patients with aphasia after stroke. J Neurol. 2011;258(2):343–9.PubMedCrossRef
27.
Gialanella B, Bertolinelli M, Lissi M, Prometti P. Predicting outcome after stroke: the role of aphasia. Disabil Rehabil. 2011;33(2):122–9.PubMedCrossRef
28.
Hilari K. The impact of stroke: are people with aphasia different to those without? Disabil Rehabil. 2011;33(3):211–8.PubMedCrossRef
29.
Flowers HL, Silver FL, Fang J, Rochon E, Martino R. The incidence, co-occurrence, and predictors of dysphagia, dysarthria, and aphasia after first-ever acute ischemic stroke. J Commun Disord. 2013;46(3):238–48.PubMedCrossRef
30.
Schnakers C, Bessou H, Rubi-Fessen I, Hartmann A, Fink GR, Meister I, Giacino JT, Laureys S, Majerus S. Impact of aphasia on consciousness assessment: a cross-sectional study. Neurorehabil Neural Repair. 2015;29(1):41–7.PubMedCrossRef
31.
32.
Flowers HL, AlHarbi MA, Mikulis D, Silver FL, Rochon E, Streiner D, Martino R. MRI-Based Neuroanatomical Predictors of Dysphagia Dysarthria, and Aphasia in Patients with First Acute Ischemic Stroke. Cerebrovasc Dis Extra. 2017;7(1):21–34.PubMedPubMedCentralCrossRef
33.
González Mc F, Lavados GP, Olavarría IV. Incidence of aphasia in patients experiencing an ischemic stroke. Rev Med Chil. 2017;145(2):194–200.PubMedCrossRef
34.
Ginex V, Veronelli L, Vanacore N, Lacorte E, Monti A, Corbo M. Motor recovery in post-stroke patients with aphasia: the role of specific linguistic abilities. Top Stroke Rehabil. 2017;24(6):428–34.PubMedCrossRef
35.
Gonzalez R, Rojas M, Ardila A. Alexia and agraphia in Spanish. Int J Lang Commun Disord. 2020;55(6):875–83.PubMedCrossRef
36.
García-Rudolph A, García-Molina A, Cegarra B, Opisso E, Saurí J, Tormos JM, Bernabeu M. Subacute ischemic stroke rehabilitation outcomes in working-age adults: The role of aphasia in cognitive functional independence. Top Stroke Rehabil. 2021;28(5):378–89.PubMedCrossRef
37.
Xu S, Yan Z, Pan Y, Yang Q, Liu Z, Gao J, Yang Y, Wu Y, Zhang Y, Wang J, et al. Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study. Behav Neurol. 2021;2021:9417173.PubMedPubMedCentralCrossRef
38.
Goldberg EB, Meier EL, Sheppard SM, Breining BL, Hillis AE. Stroke Recurrence and Its Relationship With Language Abilities. J Speech Lang Hear Res. 2021;64(6):2022–37.PubMedPubMedCentralCrossRef
39.
Grönberg A, Henriksson I, Lindgren A. Accuracy of NIH Stroke Scale for diagnosing aphasia. Acta Neurol Scand. 2021;143(4):375–82.PubMedCrossRef
40.
Lin HL, Tsai CF, Liu SP, Muo CH, Chen PC. Association between aphasia and risk of dementia after stroke. J Stroke Cerebrovasc Dis. 2022;31(12): 106838.PubMedCrossRef
41.
Wilson SM, Entrup JL, Schneck SM, Onuscheck CF, Levy DF, Rahman M, Willey E, Casilio M, Yen M, Brito AC, et al. Recovery from aphasia in the first year after stroke. Brain. 2023;146(3):1021–39.PubMedCrossRef
42.
Brogan EL, Kim J, Grimley RS, Wallace SJ, Baker C, Thayabaranathan T, Andrew NE, Kilkenny MF, Godecke E, Rose ML, et al. The Excess Costs of Hospitalization for Acute Stroke in People With Communication Impairment: A Stroke123 Data Linkage Substudy. Arch Phys Med Rehabil. 2023;104(6):942–9.PubMedCrossRef
43.
Acharya AB, Wroten M: Broca Aphasia. In: StatPearls. Treasure Island (FL): StatPearls PublishingCopyright © 2022, StatPearls Publishing LLC.; 2022.
44.
Chuang YC, Liu CC, Yu IC, Tsai YL, Chang ST. Shifting of global aphasia to Wernicke’s aphasia in a patient with intact motor function: a case report. BMC Neurol. 2021;21(1):111.PubMedPubMedCentralCrossRef
45.
Bitan T, Lifshitz A, Breznitz Z, Booth JR. Bidirectional connectivity between hemispheres occurs at multiple levels in language processing but depends on sex. J Neurosci. 2010;30(35):11576–85.PubMedPubMedCentralCrossRef
46.
Peper JS, Burke SM, Wierenga LM. Sex differences and brain development during puberty and adolescence. Handb Clin Neurol. 2020;175:25–54.PubMedCrossRef
47.
Liu LS, Zhao JL, He YL, Song YJ, Zeng XF. The 490th case: arthralgia, amenorrhea, aphasia. Zhonghua Nei Ke Za Zhi. 2021;60(12):1189–92.PubMed
48.
Xu M, Liang X, Ou J, Li H, Luo YJ, Tan LH. Sex Differences in Functional Brain Networks for Language. Cereb Cortex. 2020;30(3):1528–37.PubMedCrossRef
49.
Miao L, Yang S, Yi Y, Tian P, He L. Research on the prediction of longevity from both individual and family perspectives. PLoS ONE. 2022;17(2):e0263992.PubMedPubMedCentralCrossRef
50.
Purroy F, Vena A, Forné C, de Arce AM, Dávalos A, Fuentes B, Arenillas JF, Krupinski J, Gómez-Choco M, Palomeras E, et al. Age- and Sex-Specific Risk Profiles and In-Hospital Mortality in 13,932 Spanish Stroke Patients. Cerebrovasc Dis. 2019;47(3–4):151–64.PubMedCrossRef
51.
Thye M, Mirman D. Relative contributions of lesion location and lesion size to predictions of varied language deficits in post-stroke aphasia. Neuroimage Clin. 2018;20:1129–38.PubMedPubMedCentralCrossRef
52.
Kasselimis DS, Simos PG, Peppas C, Evdokimidis I, Potagas C. The unbridged gap between clinical diagnosis and contemporary research on aphasia: A short discussion on the validity and clinical utility of taxonomic categories. Brain Lang. 2017;164:63–7.PubMedCrossRef
53.
Fridriksson J, den Ouden DB, Hillis AE, Hickok G, Rorden C, Basilakos A, Yourganov G, Bonilha L. Anatomy of aphasia revisited. Brain. 2018;141(3):848–62.PubMedPubMedCentralCrossRef
54.
Hybbinette H, Schalling E, Plantin J, Nygren-Deboussard C, Schütz M, Östberg P, Lindberg PG. Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke. Front Neurol. 2021;12:634065.PubMedPubMedCentralCrossRef
55.
Vigliecca NS. Validity and features of spontaneous speech in acute aphasia as evaluated with the Brief Aphasia Evaluation: is fluent aphasia more severe than nonfluent aphasia? Codas. 2019;31(1):e20180048.PubMedCrossRef
56.
Lee S, Na Y, Tae WS, Pyun SB. Clinical and neuroimaging factors associated with aphasia severity in stroke patients: diffusion tensor imaging study. Sci Rep. 2020;10(1):12874.PubMedPubMedCentralCrossRefADS
57.
Zhu Z, Deng J, Li M, Qin Y, Li J, Yang Y. Processing speed mediates the relationship between brain structure and semantic fluency in aging. Neurosci Lett. 2022;788:136838.PubMedCrossRef
58.
Kaczkurkin AN, Raznahan A, Satterthwaite TD. Sex differences in the developing brain: insights from multimodal neuroimaging. Neuropsychopharmacology. 2019;44(1):71–85.PubMedCrossRef
59.
Dreier JP, Lemale CL, Kola V, Friedman A, Schoknecht K. Spreading depolarization is not an epiphenomenon but the principal mechanism of the cytotoxic edema in various gray matter structures of the brain during stroke. Neuropharmacology. 2018;134(Pt B):189–207.PubMedCrossRef
60.
Ellis C, Urban S. Age and aphasia: a review of presence, type, recovery and clinical outcomes. Top Stroke Rehabil. 2016;23(6):430–9.PubMedCrossRef
61.
Shafto MA, Tyler LK. Language in the aging brain: the network dynamics of cognitive decline and preservation. Science. 2014;346(6209):583–7.PubMedCrossRefADS
62.
Gajardo-Vidal A, Lorca-Puls DL, Team P, Warner H, Pshdary B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, et al. Damage to Broca’s area does not contribute to long-term speech production outcome after stroke. Brain. 2021;144(3):817–32.PubMedPubMedCentralCrossRef
63.
Hazamy AA, Obermeyer J. Evaluating informative content and global coherence in fluent and non-fluent aphasia. Int J Lang Commun Disord. 2020;55(1):110–20.PubMedCrossRef
64.
Minkina I, Martin N, Spencer KA, Kendall DL. Links Between Short-Term Memory and Word Retrieval in Aphasia. Am J Speech Lang Pathol. 2018;27(1s):379–91.PubMedPubMedCentralCrossRef
65.
Theofilidis A, Karakasi MV, Kevrekidis DP, Pavlidis P, Sofologi M, Trypsiannis G, Nimatoudis J. Gender Differences in Short-term Memory Related to Music Genres. Neuroscience. 2020;448:266–71.PubMedCrossRef
66.
Delikishkina E, Lingnau A, Miceli G. Neural correlates of object and action naming practice. Cortex. 2020;131:87–102.PubMedCrossRef
67.
Kalita J, Bharadwaz MP, Aditi A. Prevalence, contributing factors, and economic implications of strokes among older adults: a study of North-East India. Sci Rep. 2023;13(1):16880.PubMedPubMedCentralCrossRefADS
Metadata
Title
Meta-analysis and systematic review of the relationship between sex and the risk or incidence of poststroke aphasia and its types
Authors
Ting-ting Li
Ping-ping Zhang
Ming-chen Zhang
Hui Zhang
Hong-ying Wang
Ying Yuan
Shan-lin Wu
Xiao-wen Wang
Zhong-guang Sun
Publication date
01-12-2024
Publisher
BioMed Central
Keywords
Aphasia
Stroke
Published in
BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-024-04765-0

Other articles of this Issue 1/2024

BMC Geriatrics 1/2024 Go to the issue

Research

Older adults experience of transition to the community from the emergency department: a qualitative evidence synthesis

Research

Adaptation of a guided low-intensity behavioral activation intervention for people with dementia in Sweden: a qualitative study exploring the needs and preferences of key stakeholders

Research

Working retirees in Taiwan: examining determinants of different working status after retirement

Research

Latent class of multidimensional dependency in community-dwelling older adults: evidence from the longitudinal ageing study in India

Research

Introducing a pharmacist-led transmural care program to reduce drug-related problems in orthogeriatric patients: a prospective interventional study

Research

Disentangling drug contributions: anticholinergic burden in older adults linked to individual medications: a cross-sectional population-based study
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits