Aphasia and return to work in younger stroke survivors

Background: Younger stroke patients (i.e., typically those between 18 and 65 years of age) experience fewer stokes than older patients. However, younger stroke survivors are more likely to live longer with disability, have dependants, and be engaged in full-or part-time employment. Aphasia post stroke occurs in 10% of younger survivors, and can significantly impact the ability to resume previous activities of daily living. Unfortunately traditional rehabilitation often does not account for language impairments that impact vocational status. Aims: This review reports the rate of successful return to work (RTW) for younger stroke survivors with aphasia. Aphasia is consistently regarded as a barrier to an individual's ability to RTW post stroke. However, the degree to which working-age stroke survivors with aphasia successfully RTW remains unknown. In addition, conflicting evidence has been found as to the predictive nature of communication impairments on RTW. Main Contribution: The primary outcome in which we were interested was the degree to which younger survivors with aphasia return to work. Secondary outcomes were the type of assessment used, the definition of work, and the age of the study sample. Nine studies were identified (aphasia N = 415, total N = 1612). The average rate of successful RTW for young survivors with aphasia was 28.4% compared to 44.7% for all young stroke survivors. Conclusions: Younger survivors with aphasia were less likely to RTW post stroke than those without aphasia. Strategies to reduce this disparity, such as specialised vocational rehabilitation, should be made available to this population.