Racial-Ethnic Differences in Word Fluency and Auditory Comprehension Among Persons With Poststroke Aphasia

Abstract Objectives To examine aphasia outcomes and to determine whether the observed language profiles vary by race-ethnicity. Design Retrospective cross-sectional study using a convenience sample of persons of with aphasia (PWA) obtained from AphasiaBank, a database designed for the study of aphasia outcomes. Setting Aphasia research laboratories. Participants PWA (N=381; 339 white and 42 black individuals). Interventions Not applicable. Main Outcome Measures Western Aphasia Battery–Revised (WAB-R) total scale score (Aphasia Quotient) and subtest scores were analyzed for racial-ethnic differences. The WAB-R is a comprehensive assessment of communication function designed to evaluate PWA in the areas of spontaneous speech, auditory comprehension, repetition, and naming in addition to reading, writing, apraxia, and constructional, visuospatial, and calculation skills. Results In univariate comparisons, black PWA exhibited lower word fluency (5.7 vs 7.6; P =.004), auditory word comprehension (49.0 vs 53.0; P =.021), and comprehension of sequential commands (44.2 vs 52.2; P =.012) when compared with white PWA. In multivariate comparisons, adjusted for age and years of education, black PWA exhibited lower word fluency (5.5 vs 7.6; P =.015), auditory word recognition (49.3 vs 53.3; P =.02), and comprehension of sequential commands (43.7 vs 53.2; P =.017) when compared with white PWA. Conclusions This study identified racial-ethnic differences in word fluency and auditory comprehension ability among PWA. Both skills are critical to effective communication, and racial-ethnic differences in outcomes must be considered in treatment approaches designed to improve overall communication ability.