Social network composition influences chronic post-stroke aphasia recovery

Background Social networks are vital for maintaining cognitive health and emotional well-being, particularly in aging populations. In persons with aphasia (PWA), communication challenges following stroke may disrupt social relationships, leading to smaller, less diverse networks and potentially impacting recovery outcomes. While prior research has explored social participation in stroke survivors, few studies have quantitatively examined how social network structure relates to language recovery in PWA.Aims This study aimed to (1) describe the social network structure of PWA, (2) examine demographic and clinical predictors of social network characteristics, and (3) evaluate to what extent social network variables are associated with longitudinal change in aphasia severity, as measured by change in Western Aphasia Battery – Revised Aphasia Quotient (WAB-R AQ) scores.Methods Data were drawn from 43 PWA in the chronic phase of stroke recovery. Social network metrics (degree, closeness, density, and alter closeness) were derived from semi-structured interviews with PWA and caregivers and normatively compared to data from unimpaired adults. Clinical and psychosocial variables included fluency classification, WAB-R AQ, perceived social support, quality of life, and demographic data. A subset of 29 participants had WAB-R AQ scores from two timepoints, allowing for analysis of language change. Regression models and ANOVA comparisons were used to evaluate predictors of network structure and language recovery.Results PWA had significantly smaller social networks (M = 2.8 social partners, or “alters”) compared to healthy older adults (M = 3.56). Regression models identified fluency, younger stroke age, and higher perceived social support as significant predictors of social closeness. Longitudinal models revealed that lower social network density significantly predicted greater improvement in WAB-R AQ scores over time. Demographic and psychosocial factors also contributed to variability in recoveryConclusion Findings suggest that both the size and structure of social networks are meaningfully associated with language recovery in PWA, possibly in a causal manner, even if not necessarily unidirectional. Clinically, these results highlight the need for interventions that support diverse, expansive social connections and emphasize the role of social participation in aphasia rehabilitation. Incorporating social network assessments into therapy planning may enhance outcomes by addressing not only linguistic deficits but also the social environments that sustain communication.