RESUMO
PURPOSE: This study had twofold objective: (1) assessing change and dynamic processes over time between severity of aphasia and functional autonomy and (2) examining the temporal relationships between functional autonomy, depressive mood and quality of life in stroke patients with aphasia. METHOD: Prospective study of patients with aphasia consecutively included after a first stroke and examined 1 year later at home (n = 101). Assessment included a visual analogical scale assessing QoL, a functional autonomy scale, a severity of aphasia scale, a communication questionnaire and a depression scale. Structural equation modeling was used to estimate competitive models, in which depressive mood or QoL was the ultimate endogenous variable (i.e., vulnerability vs. scar model). RESULTS: One year after stroke, there were a slight improvement in language impairment (stability coefficient = .61, p < .001) and a moderate improvement in functional autonomy (stability coefficient = .44, p < .001). There were prospective reciprocal effects between severity of aphasia and functional autonomy, i.e., each state exerted a temporal dynamic prediction on the other over time. Cross-sectional results from path analysis showed that depressive mood negatively predicted QoL (i.e., scar model); there was no evidence of the reverse association. CONCLUSION: Results and their practical relevance in treatment were discussed. Predicting as soon as possible which factors would be related to late QoL in stroke patients with aphasia is of major importance.
