Assessment of cognition in aphasia: perspectives from clinicians and researchers

People with aphasia may present with cognitive impairments beyond language. In this population, reliance on language-based assessments of cognition may lead to unreliable metrics of cognitive performance across clinical and research settings. We investigated the underlying philosophy and practice of assessing cognition in people with aphasia. An e-survey was developed for multidisciplinary clinicians and researchers. Snowball sampling was used to recruit international participants. The e-survey comprised 29 items (a mix of multiple-choice and open-ended items) addressing definitions of cognition, assessment of cognition, tools used to assess cognition and participant demographics. Data were analysed using descriptive statistics and thematic analysis. 291 respondents participated from a range of disciplines and countries. Over 80% of respondents considered it important to assess attention, executive functions, learning and memory. The main barrier to assessment was the lack of appropriate tools available for people with aphasia. Responses indicated that whilst professionals felt that understanding the interaction between language and cognition in aphasia was important for providing optimal care. This study highlights the need for better awareness and training in the assessment of cognition in people with aphasia, and for psychometrically robust assessments, appropriate for the assessment of cognition in the presence of aphasia.