Clinical and prognostic properties of standardized and functional aphasia assessments.

OBJECTIVE: To compare standardized and functional aphasia tests in patients after acute stroke.

DESIGN: Data were collected at baseline and at 6 months in 2 prospective single-centre studies: one observational study (study I, n=119) and one randomized trial of moclobemide vs placebo (study II, n=89).

SUBJECTS: Patients with aphasia after acute stroke.

METHODS: Degree of aphasia was examined using the Coefficient (Coeff) in Norsk Grunntest for Afasi (standardized) and the Amsterdam-Nijmegen Everyday Language Test (ANELT) (functional). Statistical comparisons were made using one-way analysis of variance and multivariate regression analyses.

RESULTS: The degree of aphasia measured with Coeff and ANELT correlated closely throughout the study (r2=0.71-0.87, p<0.0001). In study I, 24 patients recovered completely within 6 months. A Coeff >or= 49 and ANELT >or= 3.5 predicted complete recovery equally well. Coeff was sensitive to differentiate between patients with low values on ANELT, whereas ANELT was sensitive to differentiate between patients with high Coeff values.

CONCLUSION: The 2 tests show a close and consistent correlation over time and are equally sensitive to improvement. They have a similar capacity to predict complete recovery. A standardized test appears to be more suitable for patients with aphasia in the acute stage, while a functional test is more suitable in the subacute/chronic stage.