Aphasia is a communication disorder associated with impairments in spoken language, understanding, reading and writing that impacts upon daily activities, participation in society and the quality of life (QoL), and it is common in elderly patients in the context of vascular diseases. We aimed to investigate participation in society and the environmental factors and health-related QoL of elderly people with aphasia.

People with aphasia whose age was above 65 were included in this study. QoL was assessed by the Japanese version of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) and Life stage Aphasia Quality Of Life scale-11 (LAQOL-11), and the participation in society and the environmental factors as barriers was assessed by the Japanese version of the Community Integration Questionnaire (CIQ) and the Japanese version 2 of the Craig Hospital Inventory of Environmental Factors (CHIEF), respectively. We explored predictors such as aphasia severity, communication impairment, cognitive functions, motor paralysis, activities of daily living (ADL).

We included 58 individuals (43 men; mean age 73.2 [SD 5.7] years) with aphasia after the mean 48 (SD 64.9) months of onset (of stroke, cerebral hemorrhage, subarachnoid hemorrhage, brain tumor, traumatic brain injury). The median of the total score of SAQOL-39 and LAQOL-11 was 3.91 (Quartile Deviation 0.47) out of 5 and 85.0 (QD 12.5) out of 110. The QoL was not associated with aphasia severity assessed by the Standard Language Test of Aphasia (SLTA) which is the most frequently used comprehensive aphasia rating scale in Japan, but poor QoL was significantly associated (Spearman correlations) with increased severity of communication impairment assessed by Communication ADL Test (P = 0.01). Moreover, increased QoL was significantly associated with increased participation in society (P = 0.03) and decreased environmental factors (P = 0.01).

Poor communication ADL may have a negative effect on QoL in elderly people with aphasia. Also, we show that QoL is associated with participation in society. For patients with aphasia after retirement, specific rehabilitation of communication ADL might be beneficial and should be explored in future studies.