Abstract
Introduction: Aphasia persists in about one third of the patients with left hemisphere stroke, yet it is not known if it enhances the risk of dementia, beyond what results from any focal brain lesion. This lack of knowledge is mostly related to the difficulty of cognitive evaluation in people with aphasia. The development of tools aiming to assess cognitive functioning in people with aphasia could overcome this limitation. The aim of this systematic review was to evaluate the frequency and the profile of cognitive impairment in stroke patients with aphasia, to assemble existing non-verbal instruments to be used in patients with language disorders.
Methods: We conducted a systematic review, through Web of Science, Medline and PsycINFO electronic databases, of articles published between January 1995 and October 31, 2015 related to aphasia due to stroke and non-verbal neurobehavioral tests.
Results: The electronic search identified 2487 citations. After screening 38 were included in this review. Additionally 53 articles were selected among the references of analyzed publications of which nine were included producing a total of 47 articles. The cognitive tests more frequently used in persons with aphasia are the Figures Memory Tests, Visual Memory Span, Progressive Matrices, Wisconsin Card Sorting Test and some measures of the Test of Everyday Attention, covering a reasonable range of cognitive domains. The majority of studies across cognitive domains reported lower scores for patients with aphasia compared with controls. No specific difficulties were reported regarding tests applicability.
Conclusion: There are several tools available to assess cognitive functions in aphasia. Although there is some variability, patients with aphasia tend to present lower scores than those with left hemisphere stroke without aphasia or healthy subjects. A consensus tool should be developed to screen or evaluate cognition and dementia in individuals with language impairment.
Acknowledgments
We are grateful to Inês Mares for her assistance with the English.
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