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Looking Upstream to Understand Race/Ethnicity as a Moderator for Poststroke Neuroinflammation and a Social Determinant for Poststroke Aphasia Outcomes.

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Title: Looking Upstream to Understand Race/Ethnicity as a Moderator for Poststroke Neuroinflammation and a Social Determinant for Poststroke Aphasia Outcomes.
Authors: Evans, Elizabeth1 evans.e@phhp.ufl.edu, Ellis, Charles1
Source: American Journal of Speech-Language Pathology. Jan2024, Vol. 33 Issue 1, p74-86. 13p.
Subject Terms: *Alzheimer's disease, *Cognition, *Aphasia, *Mental depression, Racism, Evaluation of medical care, Cognition disorders, Stroke, Social determinants of health, Convalescence, Neuroinflammation, Risk assessment, Conceptual structures, Segregation, Severity of illness index, Psychosocial factors, Stroke patients, Dementia, Health equity, Neighborhood characteristics, Comorbidity, Disease risk factors, Disease complications
Abstract: Introduction: Over the past decade, the stroke literature has begun to acknowledge and explore explanations for longstanding racial/ethnic differences in stroke outcomes. Poststroke cognitive impairment (PSCI) and poststroke aphasia are two such negative poststroke outcomes where racial/ethnic differences exist. Physiological differences, such as stroke type and lesion size, have been used to partially explain the variation in PSCI and aphasia. However, there is some evidence, although limited, that suggests neuroinflammatory processes as part of allostatic load may be a key contributor to the observed disparities. Method: In this tutorial, we explore the influence of race differences in inflammation on poststroke cognitive outcomes. We suggest lifetime stress and other external determinants of health such as neighborhood environment and discriminatory practices through "weathering" explain differences in inflammation. While using an allostatic load framework, we explore the literature focusing specifically on the role of neuroinflammation on poststroke outcomes. Conclusions: Examination of the immune response poststroke provides a foundation for understanding the mechanisms of PSCI and poststroke aphasia and the potential contributions of neuroinflammatory processes on poststroke cognitive outcomes. Furthermore, understanding of racial differences in those processes may contribute to a better understanding of racial disparities in general stroke outcomes as well as poststroke aphasia. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Label: Title
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  Data: Looking Upstream to Understand Race/Ethnicity as a Moderator for Poststroke Neuroinflammation and a Social Determinant for Poststroke Aphasia Outcomes.
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  Data: <searchLink fieldCode="AR" term="%22Evans%2C+Elizabeth%22">Evans, Elizabeth</searchLink><relatesTo>1</relatesTo><i> evans.e@phhp.ufl.edu</i><br /><searchLink fieldCode="AR" term="%22Ellis%2C+Charles%22">Ellis, Charles</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Speech-Language+Pathology%22">American Journal of Speech-Language Pathology</searchLink>. Jan2024, Vol. 33 Issue 1, p74-86. 13p.
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  Data: *<searchLink fieldCode="DE" term="%22Alzheimer's+disease%22">Alzheimer's disease</searchLink><br />*<searchLink fieldCode="DE" term="%22Cognition%22">Cognition</searchLink><br />*<searchLink fieldCode="DE" term="%22Aphasia%22">Aphasia</searchLink><br />*<searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Racism%22">Racism</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+medical+care%22">Evaluation of medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition+disorders%22">Cognition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Social+determinants+of+health%22">Social determinants of health</searchLink><br /><searchLink fieldCode="DE" term="%22Convalescence%22">Convalescence</searchLink><br /><searchLink fieldCode="DE" term="%22Neuroinflammation%22">Neuroinflammation</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Conceptual+structures%22">Conceptual structures</searchLink><br /><searchLink fieldCode="DE" term="%22Segregation%22">Segregation</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Dementia%22">Dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Health+equity%22">Health equity</searchLink><br /><searchLink fieldCode="DE" term="%22Neighborhood+characteristics%22">Neighborhood characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: Over the past decade, the stroke literature has begun to acknowledge and explore explanations for longstanding racial/ethnic differences in stroke outcomes. Poststroke cognitive impairment (PSCI) and poststroke aphasia are two such negative poststroke outcomes where racial/ethnic differences exist. Physiological differences, such as stroke type and lesion size, have been used to partially explain the variation in PSCI and aphasia. However, there is some evidence, although limited, that suggests neuroinflammatory processes as part of allostatic load may be a key contributor to the observed disparities. Method: In this tutorial, we explore the influence of race differences in inflammation on poststroke cognitive outcomes. We suggest lifetime stress and other external determinants of health such as neighborhood environment and discriminatory practices through "weathering" explain differences in inflammation. While using an allostatic load framework, we explore the literature focusing specifically on the role of neuroinflammation on poststroke outcomes. Conclusions: Examination of the immune response poststroke provides a foundation for understanding the mechanisms of PSCI and poststroke aphasia and the potential contributions of neuroinflammatory processes on poststroke cognitive outcomes. Furthermore, understanding of racial differences in those processes may contribute to a better understanding of racial disparities in general stroke outcomes as well as poststroke aphasia. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1044/2023_AJSLP-23-00315
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 74
    Subjects:
      – SubjectFull: Alzheimer's disease
        Type: general
      – SubjectFull: Cognition
        Type: general
      – SubjectFull: Aphasia
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Racism
        Type: general
      – SubjectFull: Evaluation of medical care
        Type: general
      – SubjectFull: Cognition disorders
        Type: general
      – SubjectFull: Stroke
        Type: general
      – SubjectFull: Social determinants of health
        Type: general
      – SubjectFull: Convalescence
        Type: general
      – SubjectFull: Neuroinflammation
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Conceptual structures
        Type: general
      – SubjectFull: Segregation
        Type: general
      – SubjectFull: Severity of illness index
        Type: general
      – SubjectFull: Psychosocial factors
        Type: general
      – SubjectFull: Stroke patients
        Type: general
      – SubjectFull: Dementia
        Type: general
      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Neighborhood characteristics
        Type: general
      – SubjectFull: Comorbidity
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Disease complications
        Type: general
    Titles:
      – TitleFull: Looking Upstream to Understand Race/Ethnicity as a Moderator for Poststroke Neuroinflammation and a Social Determinant for Poststroke Aphasia Outcomes.
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            NameFull: Evans, Elizabeth
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            NameFull: Ellis, Charles
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            – D: 01
              M: 01
              Text: Jan2024
              Type: published
              Y: 2024
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            – TitleFull: American Journal of Speech-Language Pathology
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